Organization
HIS COVENANT CARE HOME, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA A PEOPLES (CEO)
(252) 268-0411
Entity
Organization
Contact information
Practice address
804 PAYLOR DR, KINSTON, NC 28501-1849
(252) 268-0411
Mailing address
2202 GREENBRIAR RD, KINSTON, NC 28501-2136
(252) 268-0411
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-054-132
NC
Other
Enumeration date
11/02/2007
Last updated
11/02/2007
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