Organization
PROFESSIONAL GROUP LIVING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NATALKA LOCK MASSEY (EXECUTIVE DIRECTOR)
(919) 475-5845
Entity
Organization
Contact information
Practice address
510 SIMMONS ST, DURHAM, NC 27701-4334
(919) 475-5845
(919) 688-0918
Mailing address
423B S. CHESTNUT STREET, HENDERSON, NC 27536
(919) 475-5845
(252) 492-3209
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
02/15/2008
Last updated
02/15/2008
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