Organization
NEW IMAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG POWELL (C.E.O)
(252) 267-2833
Entity
Organization
Contact information
Practice address
408 SHEPARD ST, ELIZABETH CITY, NC 27909-5260
(252) 267-2833
Mailing address
408 SHEPARD ST, ELIZABETH CITY, NC 27909-5260
(252) 267-2833
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
5354758
NC
Other
Enumeration date
08/09/2012
Last updated
08/09/2012
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