Organization
SOPHIA B PIERCE & ASSOCIATES INC
Active
Other names
Northside Group Home
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SOPHIA BLANKS PIERCE EDD (EXECUTIVE DIRECTIVE)
(910) 488-8477
Entity
Organization
Contact information
Practice address
3301 BARKSDALE ROAD, FAYETTEVILLE, NC 28301
(910) 822-4455
(910) 822-4455
Mailing address
PO BOX 2813, FAYETTEVILLE, NC 28302
(910) 822-4455
(910) 822-4455
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
MHL026125
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3406042
—
NC
Enumeration date
10/26/2006
Last updated
12/03/2018
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