Organization
ABUNDANT LIFE TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GERENDA LATRICE WILLIAMS (CEO)
(252) 883-1670
Entity
Organization
Contact information
Practice address
108 W HOPE LODGE ST, TARBORO, NC 27886-2439
(252) 774-4100
(252) 774-4100
Mailing address
PO BOX 1427, TARBORO, NC 27886-1427
(252) 774-4100
(252) 774-4100
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
033097
NC
Other
Enumeration date
04/04/2011
Last updated
04/04/2011
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