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COMMUNITY INNOVATIONS INC 66

Intermediate Care Facility, Mentally Retarded

Liberty, North Carolina

Provider NPI: 1932286010

Organization Information:
Organization Name:  COMMUNITY INNOVATIONS INC 66


Practice Location:
313 EAST BROOKWOOD AVENUE  LIBERTY, NC 27298 US
Tel: 336-622-3003  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y315P00000XNursing & Custodial Care Facilities
Intermediate Care Facility, Mentally Retarded
NCMHL076022

Other Provider Identifiers:

IssuerNumberStateType
340608FNC05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




MENTALLY RETARDED JOBS NC - Page 1



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