Organization
WILLIAMS GROUP HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMY MONROE BACHELOR OF ARTS (DIRECTOR)
(910) 259-7677
Entity
Organization
Contact information
Practice address
2161 NEW RD, BURGAW, NC 28425-3143
(910) 259-7677
(910) 259-6009
Mailing address
PO BOX 696, BURGAW, NC 28425-0696
(910) 259-7677
(910) 259-6009
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL071-020
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603788
—
NC
Enumeration date
12/08/2006
Last updated
08/22/2020
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