Organization
WOODED ACRES GUEST HOME #1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES E HARDISON JR. (OWNER)
(252) 946-6245
Entity
Organization
Contact information
Practice address
3706 CHERRY RD, WASHINGTON, NC 27889-7268
(252) 946-6245
(252) 946-6245
Mailing address
3706 CHERRY RD, WASHINGTON, NC 27889-7268
(252) 946-6245
(252) 946-6245
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
MHL007053
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7801354
—
NC
Enumeration date
05/24/2007
Last updated
08/22/2020
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