Organization
MODERATE LIVING FOR THE AGING INC
Active
Organization
MODERATE LIVING FOR THE AGING INC
Active
Other names
Mt. Gilead Independent Senior and Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MYSTERY E WILLIS (CEO)
(910) 439-1669
Entity
Organization
Contact information
Practice address
110 ROOSEVELT ST, MOUNT GILEAD, NC 27306-9606
(910) 439-1635
Mailing address
PO BOX 1312, MOUNT GILEAD, NC 27306-1312
(910) 439-1669
(888) 351-5666
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
90368
NC
310400000X
Assisted Living Facility
902768
NC
347E00000X
Transportation Broker
—
—
Other
Enumeration date
01/27/2016
Last updated
12/01/2021
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