Organization
THE JOHN OLIVER CENTER #3
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN OLIVER JR. (EXECUTIVE DIRECTOR)
(919) 739-5859
Entity
Organization
Contact information
Practice address
535 BROGDEN ST, DUDLEY, NC 28333-8187
(919) 736-2135
(919) 735-9745
Mailing address
PO BOX 1504, GOLDSBORO, NC 27533-1504
(919) 739-5859
(919) 735-9745
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL096140
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603798
—
NC
Enumeration date
06/27/2007
Last updated
08/22/2020
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