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Organization

NEW RIVER COTTAGE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. DARLENE DOUGLAS MS (EXECUTIVE DIRECTOR)
(336) 372-5671
Entity
Organization

Contact information

Practice address
82 DAVIS LANE, SPARTA, NC 28675-0488
(336) 372-5671
(336) 372-5672
Mailing address
PO BOX 488, 82 DAVIS LANE, SPARTA, NC 28675-0488
(336) 372-5671
(336) 372-5672

Taxonomy

Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
MHL003003
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
MHL003003
NC
Enumeration date
08/03/2006
Last updated
08/22/2020
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