Organization
PEOPLE OF POTENTIAL, INC
Active
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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