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Organization

UNIVERSAL GROUP HOME LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SANDRA FAYE SPRUILL (DIRECTOR)
(919) 344-8846
Entity
Organization

Contact information

Practice address
609 E MAIN ST, MOUNT OLIVE, NC 28365-2248
(919) 344-8846
Mailing address
411 FOREST DR, GOLDSBORO, NC 27534-3323
(919) 344-8846

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
MHL-031-075
NC
311ZA0620X
Adult Care Home Facility
MHL-096-254
NC
311ZA0620X
Adult Care Home Facility
Primary
MHL-096-255
NC

Other

Enumeration date
08/20/2014
Last updated
08/20/2014
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