Organization
PITT COUNTY GROUP HOME BOARD FOR MENTALLY RETARDED, AUTISTIC PERSONS,
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY GRACE BRIGHT (EXECUTIVE DIRECTOR)
(252) 524-4950
Entity
Organization
Contact information
Practice address
4263 N EDGE RD, AYDEN, NC 28513-7185
(252) 524-4950
(252) 524-3870
Mailing address
PO BOX 9, GRIFTON, NC 28530-0009
(252) 524-4950
(252) 524-3870
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL-074-015
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3406530
—
NC
Enumeration date
09/13/2012
Last updated
11/16/2012
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