Willow Road Facility

LBN: Willow Road Facility
Willow Road Facility is an health care organization with primary practice located at 474 Macon Embro Rd , Macon NC 27551-9285. 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. Willow Road Facility can be contacted via phone (252) 257-1814, or through Williams, Cornelius via phone (252) 257-1814.

Contact Information

Primary practice address
474 Macon Embro Rd Macon NC 27551-9285
Phone: (252) 257-1814
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Williams, Cornelius
Phone: (252) 257-1814

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320600000X MHL-093-034 North Carolina

Profile Details

NPI number 1730366089
LBN Legal business name Willow Road Facility
DBA Doing business as
Authorized official Williams, Cornelius
Entity Organization
Organization subpart 1 No
Enumeration date Jan 29th, 2008
Last updated Jan 29th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730366089 NPPES
North Carolina MEDICAID 7804755
North Carolina MEDICAID 3418365

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