Organization
ABUNDANT LIVING GROUP HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANICE TIMPSON (DIRECTOR)
(336) 623-7669
Entity
Organization
Contact information
Practice address
438 CREEKRIDGE DR, EDEN, NC 27288-2817
(336) 623-7669
(336) 623-1139
Mailing address
438 CREEKRIDGE DR, EDEN, NC 27288-2817
(336) 623-7669
(336) 623-1139
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-079-076
NC
Other
Enumeration date
02/07/2007
Last updated
08/22/2020
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