Organization
EDWARGROUP,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. COREY DICKERSON (DIRECTOR)
(919) 734-2359
Entity
Organization
Contact information
Practice address
1301 PEELE ST, GOLDSBORO, NC 27530-6920
(919) 734-2359
(919) 734-3941
Mailing address
1301 PEELE ST, GOLDSBORO, NC 27530-6920
(919) 734-2359
(919) 734-3941
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
MHL-096-063
NC
Other
Enumeration date
01/11/2007
Last updated
08/22/2020
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