Organization
METROCORP AFFILIATES, LTD
Active
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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