NPI 1164616835

Abundant Living Group Home, INC

Organisation Emotionally Disturbed Childrens' Residential Treatment Facility Eden, NC

Practice location

Address: 438 Creekridge Dr, Eden, NC 27288-2817
Phone: (336) 623-7669
Fax: (336) 623-1139

Authorised official

Name: Janice Aniece Timpson
Title: Owner
Phone: (336) 623-7669

Registered specialties

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X Licence MHL-079-076 (NC)

Other Residential Treatment Facility, Emotionally Disturbed Children providers in North Carolina →

Registry record

NPI: 1164616835
Entity type: Organization
NPI issued: 5 Sep 2007
Record last updated: 5 Sep 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.