Organization
PEOPLE OF POTENTIAL, INC
Active
Parent organization
PEOPLE OF POTENTIAL INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PEOPLE OF POTENTIAL INC
Authorized official
MS. DAWN L MCCULLEN (PRESIDENTIAL)
(901) 989-1224
Entity
Organization
Contact information
Practice address
113 COURTLAND DR, JACKSONVILLE, NC 28546-6017
(910) 989-1224
Mailing address
1001 HENDERSON DR, JACKSONVILLE, NC 28540-7423
(910) 989-1224
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
MHL067034
NC
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
MHL067100
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3409608
—
NC
Enumeration date
04/04/2007
Last updated
09/05/2012
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