Organization
METROCORP AFFILIATES, LTD
Active
Other names
Leisure Living Care Home
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GLORIA J. ROSS RN (EXECUTIVE DIRECTOR)
(704) 933-3314
Entity
Organization
Contact information
Practice address
83 JEROME ST, LUMBERTON, NC 28358-6025
(910) 739-7592
(910) 738-7954
Mailing address
950 LANE ST, KANNAPOLIS, NC 28083-3748
(704) 933-3314
(704) 933-3320
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
MHL078182
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7805532
—
NC
Enumeration date
02/19/2007
Last updated
08/22/2020
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