Organization
A BEACON OF HOPE, HABILITATIVE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLARE CAGLE (EXECUTIVE DIRECTOR)
(910) 340-2255
Entity
Organization
Contact information
Practice address
2782 DAWSON CABIN RD, JACKSONVILLE, NC 28540-9533
(910) 989-9809
(910) 989-9809
Mailing address
2782 DAWSON CABIN RD, JACKSONVILLE, NC 28540-9533
(910) 989-9809
(910) 989-9809
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8300808
—
NC
05
—
8300808B
—
NC
Enumeration date
11/20/2006
Last updated
10/22/2007
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