Organization
IRVING FAMILY HOME
Active
Other names
Irving Family Home
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VICTORIA ANN IRVING (OWNER)
(910) 455-1241
Entity
Organization
Contact information
Practice address
112 LANCE CT, JACKSONVILLE, NC 28546-8640
(910) 455-1241
Mailing address
112 LANCE CT, JACKSONVILLE, NC 28546-8640
(910) 455-1241
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3409556
—
NC
Enumeration date
02/22/2007
Last updated
08/22/2020
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