Organization
EMMANUEL RESIDENTIAL FACILITY INC
Active
Organization
EMMANUEL RESIDENTIAL FACILITY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES E HARRIS (DIRECTOR)
(252) 341-4353
Entity
Organization
Contact information
Practice address
3300 PINETREE LANE, GREENVILLE, NC 27858-1002
(252) 355-4131
(252) 355-4337
Mailing address
2927 LANDING CIR, GRIMESLAND, NC 27837-9512
(252) 752-6353
(252) 355-4337
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
MHL074152
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603875
—
NC
Enumeration date
06/25/2008
Last updated
03/17/2015
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