Organization
HOUSEOFDAVID
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VICTOR OTIS FOSTER (OWNER DIRECTOR)
(910) 389-4324
Entity
Organization
Contact information
Practice address
209 TONI DR, JACKSONVILLE, NC 28546-4803
(910) 389-4324
(910) 388-2834
Mailing address
209 TONI DR, JACKSONVILLE, NC 28546-4803
(910) 389-4324
(910) 388-2834
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
Other
Enumeration date
03/09/2007
Last updated
09/11/2025
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