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General NPI Number Information
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NPI Number | 1487429163
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Entity Type | Organization
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Legal Business Name | HARMONY HOUSE OF MOORE COUNTY
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Dates
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Enumeration Date | 11/22/2023
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Last Update Date | 02/22/2024
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Provider Practice Location Address
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Address Line | 1180 W MASSACHUSETTS AVE
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City | SOUTHERN PINES
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State | NC
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Zip | 28387-4620
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Country | US
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Telephone | 910-691-5159
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Fax |
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Provider Business Mailing Address
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Address Line | 590 W DENNY AVE
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City | PINEBLUFF
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State | NC
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Zip | 28373-8337
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Country | US
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Telephone | 910-691-5159
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | MISS AMANDA BLAIR FAULK
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Credential | LCMHC-QS, LCAS, NCC
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Telephone | 910-691-5159
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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