Organization
FAMILY ADVANTAGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIE JAMES GILCHRIST II (CEO)
(252) 536-0600
Entity
Organization
Contact information
Practice address
289 WADE RD, SCOTLAND NECK, NC 27874-8957
(252) 826-0429
(252) 826-0449
Mailing address
289 WADE RD, SCOTLAND NECK, NC 27874-8957
(252) 536-0600
(252) 826-3999
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
04/28/2008
Last updated
01/29/2021
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