Organization
PEACE OF MIND ADULT GROUP HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ADRIAN LEE WILLIAMS (OWNER)
(252) 538-1572
Entity
Organization
Contact information
Practice address
703 BAYBERRY LN, NASHVILLE, NC 27856-1578
(252) 538-1572
(252) 459-2391
Mailing address
703 BAYBERRY LN, NASHVILLE, NC 27856-1578
(252) 538-1572
(252) 459-2391
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL-064-123
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MHL-064-123
NC DHHS
NC
Enumeration date
06/21/2011
Last updated
06/21/2011
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