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General NPI Number Information
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NPI Number | 1992910434
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Entity Type | Organization
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Legal Business Name | SARAH'S PLACE
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9 E 6TH ST
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City | WELDON
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State | NC
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Zip | 27890-1650
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Country | US
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Telephone | 252-536-2290
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Fax | 252-536-2062
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Provider Business Mailing Address
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Address Line | 9 E 6TH ST
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City | WELDON
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State | NC
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Zip | 27890-1650
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Country | US
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Telephone | 252-536-2290
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Fax | 252-536-2062
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. GOLDIE LEE GILMORE
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Credential | BS
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Telephone | 252-532-5554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number | MHL-042-045
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License Number State | NC
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