Organization
PEOPLE OF POTENTIAL, INC
Active
Organization
PEOPLE OF POTENTIAL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DAWN L MCCULLEN (PRESIDENT)
(910) 265-1756
Entity
Organization
Contact information
Practice address
1001 HENDERSON DR, JACKSONVILLE, NC 28540-7423
(910) 388-1892
(910) 378-1391
Mailing address
113 COURTLAND DR, JACKSONVILLE, NC 28546-6017
(910) 265-1756
(910) 378-1391
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
MHL067034
NC
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
MHL067100
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3409608
—
NC
Enumeration date
04/03/2007
Last updated
02/22/2013
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