Organization
THANK YOU LORD(TYL)
Active
Organization
THANK YOU LORD(TYL)
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DARRELL FRANK JOHNSON II (OWNER)
(252) 200-4218
Entity
Organization
Contact information
Practice address
2612 WINSTEAD RD, ROCKY MOUNT, NC 27804-4127
(252) 200-4218
(252) 200-4418
Mailing address
2612 WINSTEAD RD, ROCKY MOUNT, NC 27804-4127
(252) 200-4218
(252) 200-4418
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
MHL064-107
NC
Other
Enumeration date
08/12/2010
Last updated
08/12/2010
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