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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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