Organization
RESIDENTIAL LOVING CARE GROUP HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA VINSON (CEO/PRESIDENT)
(252) 539-1010
Entity
Organization
Contact information
Practice address
2924 BRYANTOWN ROAD, 105 WEST MAIN STREET, AHOSKIE, NC 27910, JACKSON, NC 27845-0000
(252) 539-1010
(252) 539-2010
Mailing address
PO BOX 681, WOODLAND, NC 27897-0681
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
NC
Other
Enumeration date
01/16/2008
Last updated
01/16/2008
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