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Organization

THE PROFESSIONAL GROUP, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ERWIN KELLY (EXECTIVE DIRECTOR)
(910) 483-2002
Entity
Organization

Contact information

Practice address
2665 RIVERCLIFF RD, FAYETTEVILLE, NC 28301-3874
(910) 826-9800
(910) 483-4004
Mailing address
PO BOX 35723, FAYETTEVILLE, NC 28303-0723
(910) 483-2002
(910) 483-4004

Taxonomy

Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL026825
NC

Other

Enumeration date
10/26/2006
Last updated
08/22/2020
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