Organization
FOREVER YOUNG GROUP CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY FLOOD EXE (EXECUTIVE DIRECTOR)
(252) 293-9815
Entity
Organization
Contact information
Practice address
207 HARRISON DR N, WILSON, NC 27893-1791
(252) 293-9815
(252) 293-9816
Mailing address
1133 CHESTNUT WOOD DR, FAYETTEVILLE, NC 28314-1890
(910) 527-0258
(910) 864-2548
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/28/2007
Last updated
09/28/2007
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