Organization
PASSIONATE CARE COMMUNITY SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LETHA MILLER (MANAGER)
(919) 581-9002
Entity
Organization
Contact information
Practice address
200 W ASH ST, SUITE 107, GOLDSBORO, NC 27530-3662
(919) 581-9002
Mailing address
200 W ASH ST, SUITE 107, GOLDSBORO, NC 27530-3662
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8301661
PROVIDER NUMBER
NC
Enumeration date
03/19/2007
Last updated
09/26/2007
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