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COMMUNITY INNOVATIONS INC 75

Intermediate Care Facility, Mentally Retarded

Richlands, North Carolina

Provider NPI: 1801971957

Organization Information:
Organization Name:  COMMUNITY INNOVATIONS INC 75


Practice Location:
359 FIRE TOWER RD  RICHLANDS, NC 28574 US
Tel: 910-455-5863  Fax: --

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


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y315P00000XNursing & Custodial Care Facilities
Intermediate Care Facility, Mentally Retarded
NCMHL067019

Other Provider Identifiers:

IssuerNumberStateType
340605YNC05
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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