Organization
ROBESON COUNTY GROUP HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GALE BAILEY (FINANCE OFFICER)
(910) 671-0818
Entity
Organization
Contact information
Practice address
2121 TURNER PL, LUMBERTON, NC 28358-3256
(910) 671-0818
(910) 671-0993
Mailing address
PO BOX 3047, LUMBERTON, NC 28359-3047
(910) 671-0818
(910) 671-0993
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
MEDICAID 3408377
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408377
—
NC
05
—
7802611
—
NC
05
—
7802612
—
NC
05
—
7802640
—
NC
Enumeration date
02/13/2007
Last updated
08/22/2020
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