Holly Street Home

NPI 1043459852 - Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities - 320600000X

NPI Details
NPI 1043459852
Enumeration Date 02/18/2009
Last Updated 12/17/2015
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Position CEO
Phone (919) 735-4736
Fax (919) 735-6825
Practice Location
GOLDSBORO NC, 27534-3033, US
Phone (919) 735-4736
Fax (919) 735-6825
Business Location
PO BOX 11077
GOLDSBORO NC, 27532-1077, US
Phone (919) 735-4736
Fax (919) 735-6825
Taxonomy Code 320600000X
License State North Carolina
License Number MHL-096-114
Remove 1043459852 NPI Number

According to our database, Holly Street Home NPI is 1043459852, taxonomy code is 320600000X and license number is MHL-096-114, license state is located at North Carolina. Holly Street Home physically located at 1509 Holly Street, Goldsboro NC, 27534-3033. NPI Number 1033115704 has the healthcare provider type.

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1043459852 NPI number is provided on an as is basis without warranty of any kind. 1043459852 is maintained by the National Plan & Provider Enumeration System. The contents of Holly Street Home are for informational purposes only.