Organization
HARVEST CARE OF NORTH CAROLINA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHANDRA R PEGUES (OWNER/DIRECTOR)
(252) 363-4122
Entity
Organization
Contact information
Practice address
1513 FOREST HILLS RD NW, WILSON, NC 27896-1553
(252) 363-4122
Mailing address
PO BOX 683, WILSON, NC 27894-0683
(252) 363-4122
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
MHL098173
NC
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
MHL--098-136
NC
Other
Enumeration date
10/05/2009
Last updated
11/16/2011
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