Living Waters Group Home #2
LBN: Living Waters Group Home #2
Living Waters Group Home #2 is an health care organization with primary practice located at 1264 Davis Bridge Rd , Parkton NC 28371-9621. The organization recently has only one registered license in Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, which is considered as the primary health care specialty.
Living Waters Group Home #2 can be contacted via phone (910) 858-1403, or through Ealy, Beverly Ann via phone (910) 717-6127.
Contact Information
Primary practice address
1264 Davis Bridge Rd
Parkton NC 28371-9621
Phone: (910) 858-1403
Fax: (910) 339-1844
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 320600000X | MHL-078-219 | North Carolina |
Profile Details
| NPI number | 1487890380 |
|---|---|
| LBN Legal business name | Living Waters Group Home #2 |
| DBA Doing business as | |
| Authorized official | Ealy, Beverly Ann |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Dec 23rd, 2008 |
| Last updated | Dec 23rd, 2008 - about 17 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487890380 | NPPES |
| North Carolina | MEDICAID | 6603850 |
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