Organization
DAVIS FARM ADULT GROUP HOME 2
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY BURGESS DAVIS (OWNER)
(252) 903-0349
Entity
Organization
Contact information
Practice address
236 GOLDEN VALLEY LANE, BATTLEBORO, NC 27809-7731
(252) 442-5000
Mailing address
236 GOLDEN VALLEY LANE, BATTLEBORO, NC 27809-7731
(252) 442-5000
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
MHL-033074
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MHL-033-074
MENTAL HEALTH GROUP HOME
NC
Enumeration date
04/20/2010
Last updated
04/20/2010
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