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Blazing Women Of God Adult Group Home INC.

Clinic/Center, Adult Mental Health in Rocky Mount, NC. Organization (NPI-2).

NPI number1689976169
StatusActive
Last updated in NPPESDec 3, 2010

Details

NPI
1689976169
Entity type
Organization (NPI-2)
Legal business name
Blazing Women Of God Adult Group Home INC.
Organization subpart
No
Enumeration date
Dec 3, 2010
Last updated
Dec 3, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0850X Clinic/Center, Adult Mental Health––Yes

Practice location

1124 Clark St
Rocky Mount, NC 27801-5735

Phone 252-212-9888

Mailing address

1124 Clark St
Rocky Mount, NC 27801-5735

Phone 252-212-9888

Authorized official

Minnie B Bullock
Adminstrator
2522129888

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