Organization Name: | HILLS DDA GROUP HOME INC |
NPI Number: | 1053595546 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ALICETINE P ROUSE (ADMINISTRATOR) |
Mailing Address: | 2017 East Ridge Cir Kinston |
State: | NC US |
Postal Code: | 28501 |
Phone Number: | 2525224869 |
Fax Number: | |
NPI Enumeration Date: | 12/20/2007 |
NPI Last Update Date: | 07/21/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0850X |
License Number: | MHL054111 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NC |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Adult Mental Health |
Taxonomy Definition: | An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |