Organization
BRUNSWICK COMMUNITY COLLEGE INTERAGENCY PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORRY BLAND (DIRECTOR)
(910) 755-7374
Entity
Organization
Contact information
Practice address
50 COLLEGE ROAD, SUPPLY, NC 28462-0030
(910) 755-7374
(910) 755-7493
Mailing address
PO BOX 30, SUPPLY, NC 28462-0030
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
MHL-010-001
NC
Other
Enumeration date
02/20/2007
Last updated
08/22/2020
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