Organization
MY BROTHER'S KEEPER OF WAYNE COUNTY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARLENA COX (CEO/QUALIFIED PROFESSIONAL)
(919) 731-4455
Entity
Organization
Contact information
Practice address
200 W ASH ST, STE 109, GOLDSBORO, NC 27530-3662
(919) 731-4455
Mailing address
200 W ASH ST, STE 109, GOLDSBORO, NC 27530-3662
(919) 731-4455
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/26/2013
Last updated
12/26/2013
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