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Organization

MBN & ASSOCIATES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MILLTRENE B NEWELL (EXECUTIVE DIRECTOR)
(919) 496-1899
Entity
Organization

Contact information

Practice address
123 BULLOCK DR, LOUISBURG, NC 27549-2742
(919) 496-1899
(919) 496-1803
Mailing address
PO BOX 1086, LOUISBURG, NC 27549-1086
(919) 496-1899
(919) 496-1803

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL035033
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7804827
NC
Enumeration date
03/26/2007
Last updated
08/22/2020
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