Organization
MANUEL'S SUPPORTIVE LIVING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BARBARA MANUEL (DIRECTOR)
(252) 527-4052
Entity
Organization
Contact information
Practice address
107 BAILEYS PARK LN, KINSTON, NC 28504-7766
(252) 527-4052
Mailing address
PO BOX 2580, KINSTON, NC 28502-2580
(252) 527-4052
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301259B
—
NC
Enumeration date
01/30/2007
Last updated
07/19/2007
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