Organization
FIELDS FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERALD KENT FIELDS JR. (OWNER)
(252) 224-0150
Entity
Organization
Contact information
Practice address
9400 US HIGHWAY 17, POLLOCKSVILLE, NC 28573-9490
(252) 224-0150
Mailing address
9400 US HIGHWAY 17, POLLOCKSVILLE, NC 28573-9490
(252) 224-0150
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
MHL-052-014
NC
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-052-014
NC
Other
Enumeration date
07/26/2007
Last updated
07/26/2007
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