Organization
DUPLIN SAMPSON GROUP HOMES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARONDA STEFFEN (ADMIN. ASSISTANT)
(910) 592-8395
Entity
Organization
Contact information
Practice address
240 N PETERSON ST, MAGNOLIA, NC 28453
(910) 592-8395
(910) 596-0005
Mailing address
826 SOUTHEAST BLVD, CLINTON, NC 28328-4322
(910) 592-8395
(910) 596-0005
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
MHL-031-038
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
780 4618
PROVIDER NUMBER
NC
Enumeration date
06/20/2007
Last updated
08/22/2020
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