Organization
THE LEARNING PALACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHIRLEY S SIMPSON (EXECUTIVE DIRECTOR)
(252) 331-2156
Entity
Organization
Contact information
Practice address
2008 CEDAR POINT CIR, ELIZABETH CITY, NC 27909-9694
(252) 331-2470
Mailing address
524 SOUTH ROAD STREET, ELIZABETH CITY, NC 27909
(252) 331-2156
(252) 335-0859
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
MHL-070-019
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603740
—
NC
Enumeration date
03/15/2007
Last updated
08/05/2008
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