Organization
BRUNSWICK COMMUNITY COLLEGE INTERAGENCY PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS KRISTA ANNE ENGELS (DIRECTOR)
(910) 755-7394
Entity
Organization
Contact information
Practice address
50 COLLEGE RD NE, BOLIVIA, NC 28422-9021
(910) 755-7394
(910) 755-7493
Mailing address
50 COLLEGE RD NE, BOLIVIA, NC 28422-9021
(910) 755-7394
(910) 755-7493
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
MHL-010-001
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3404933
—
NC
Enumeration date
07/03/2013
Last updated
07/03/2013
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