NPI 1508291683

Spirit of Excellence Community Outreach, INC

Organisation Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Jacksonville, NC

Practice location

Address: 510 Crissy Dr, Jacksonville, NC 28540-9183
Phone: (910) 219-0459
Mailing address: PO Box 752, Jacksonville, NC 28541-0752

Authorised official

Name: Chante Giselle Hines
Title: Office Manager
Phone: (910) 265-0304

Registered specialties (2)

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X Licence MHL-067-157 (NC)

Other Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in North Carolina →

Mental Illness Community Based Residential Treatment Facility

Residential Treatment Facilities Taxonomy 320800000X

Other Community Based Residential Treatment Facility, Mental Illness providers in North Carolina →

Registry record

NPI: 1508291683
Entity type: Organization
NPI issued: 9 Sep 2013
Record last updated: 10 Sep 2013

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.