MEDICARE: MOTIVATED CARING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	MHL-033-092	NC

General Provider Information

NPI Number	:	1043500572
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOTIVATED CARING

Provider Business Mailing Address
First Line	:	1205 BERMUDA RD
Second Line	:
City	:	ROCKY MOUNT
State	:	NC
Zip	:	27801-5102
Country	:	US
Telephone Number	:	252-908-1357
Fax Number	:

Provider Business Practice Location Address
First Line	:	1205 BERMUDA RD
Second Line	:
City	:	ROCKY MOUNT
State	:	NC
Zip	:	27801-5102
Country	:	US
Telephone Number	:	252-908-1357
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DIRECTOR
Name	:	MS. GRACE D. STATON
Credential	:
Telephone Number	:	252-908-1357

Provider Enumeration Date	:	04/18/2011
Last Update Date	:	04/18/2011

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Directions to “MOTIVATED CARING ” Practice Location

Language	Start Address	Practice Location

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