Guardian Light Group Home

NPI 1427177542 - Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities - 320600000X

NPI Details
NPI 1427177542
Enumeration Date 03/28/2007
Last Updated 07/25/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name ROBERTHA M ROBERTHA
Position OWNER
Phone (910) 864-3163
Fax
Practice Location
1294 HALLSBORO RD S
HALLSBORO NC, 28442-9276, US
Phone (910) 864-3163
Fax
Business Location
PO BOX 1877
WHITEVILLE NC, 28472-1877, US
Phone (910) 864-3163
Fax (910) 864-3163
Toxanomy
Taxonomy Code 320600000X
License State North Carolina
License Number MHL-024-056
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According to our database, Guardian Light Group Home NPI is 1427177542, taxonomy code is 320600000X and license number is MHL-024-056, license state is located at North Carolina. Guardian Light Group Home physically located at 1294 Hallsboro Rd S, Hallsboro NC, 28442-9276. NPI Number 1033115704 has the healthcare provider type.

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1427177542 NPI number is provided on an as is basis without warranty of any kind. 1427177542 is maintained by the National Plan & Provider Enumeration System. The contents of Guardian Light Group Home are for informational purposes only.