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Organization

DAVIS FARM ADULT GROUP HOME

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ASHLEY BURGESS DAVIS (OWNER)
(252) 903-0349
Entity
Organization

Contact information

Practice address
232 GOLDEN VALLEY LANE, BATTLEBORO, NC 27809-7731
(252) 442-5000
Mailing address
232 GOLDEN VALLEY LANE, BATTLEBORO, NC 27809-7731
(252) 442-5000

Taxonomy

Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
MHL-033-074
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MHL-033-074
MENTAL HEALTH LICENSURE NUMBER
NC
Enumeration date
04/20/2010
Last updated
04/20/2010
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