Organization
ANNASCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA ELIZABETH GIBSON (DIRECTOR)
(910) 455-6724
Entity
Organization
Contact information
Practice address
111 TIFFANY PL, JACKSONVILLE, NC 28546-7821
(910) 455-6724
Mailing address
342 CENTER ST, JACKSONVILLE, NC 28546-6726
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
MHL067148
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3409385
—
NC
05
—
8301252
—
NC
Enumeration date
01/02/2007
Last updated
08/22/2020
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