Organization
AMBLESIDE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CALEB EDWARD MINSHEW (DIRECTOR OF OPERATIONS)
(252) 747-5252
Entity
Organization
Contact information
Practice address
1 INDUSTRIAL DR, SNOW HILL, NC 28580-1334
(252) 747-5252
(252) 747-4244
Mailing address
1 INDUSTRIAL DR, SNOW HILL, NC 28580-1334
(252) 747-5252
(252) 747-4244
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
MHL-040-005
NC
251S00000X
Community/Behavioral Health Agency
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408611
—
NC
Enumeration date
03/06/2007
Last updated
05/17/2021
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