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 7 years ago
Authorized Information
Name JOHN E. JOHN
Position CEO
Phone (919) 735-4736
Fax (919) 735-6825
Practice Location
1509 HOLLY STREET
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
Toxanomy
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.

Sponsored links

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.