Organization
INGRAM HEALTH SERVICE MANNA HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS DEBORAH FAYE INGRAM (CEO)
(910) 422-2273
Entity
Organization
Contact information
Practice address
108 S HICKORY ST, ROWLAND, NC 28383-9602
(910) 422-2273
(910) 422-9889
Mailing address
675 NC HIGHWAY 71 N, MAXTON, NC 28364-8741
(910) 422-2273
(910) 422-9889
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7804866
—
NC
Enumeration date
03/06/2007
Last updated
08/22/2020
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