NPI | 1467820142 |
---|---|
Doing Business As | J. EDWARDS GROUP HOME |
Entity Type | Organization |
Authorized Contact | SHARON P. JOHNSON CEO 336-896-1323 |
Organization Subpart ? | No |
Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL-034-319) |
Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MT MHL 034 319) |
Enumeration Date | 2015-09-11 |
Last Update Date | 2018-08-21 |