Organization
AMAZING QUEENS GROUP HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TAWANDA TENIKA TILLERY (OWNER)
(252) 640-9194
Entity
Organization
Contact information
Practice address
910 JENKINS FARM RD, PINETOPS, NC 27864-7022
(252) 640-9194
Mailing address
910 JENKINS FARM RD, PINETOPS, NC 27864-7022
(252) 640-9194
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/18/2025
Last updated
06/18/2025
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