institution
Evergreen Road Facility
Intellectual and/or Developmental Disabilities Residential Treatment Facility in Rocky Mount, North Carolina
NPI 1043409584

Evergreen Road Facility is a Intellectual and/or Developmental Disabilities Residential Treatment Facility based in Columbia, NC. Evergreen Road Facility practices in Rocky Mount, NC. The NPI Number for Evergreen Road Facility is 1043409584 and holds a License No. 064-079 (North Carolina).

The current practice location address for Evergreen Road Facility is 827 Evergreen Rd, Rocky Mount, NC and can be reached out via phone at 252-446-8675. You can also correspond with Evergreen Road Facility through the mailing address at 7227 LEE DEFOREST DR, COLUMBIA, MD - 21046-3236 (mailing address contact number: ).

Location: 827 Evergreen Rd, Rocky Mount, NC, 21046-3236
institution
Provider Profile Details
NPI Number
1043409584
Provider Name
Evergreen Road Facility
Credential
Provider Entity Type
Organization
Address
827 Evergreen Rd, Rocky Mount, NC, 21046-3236
Phone Number
252-446-8675
Fax Number
Provider Enumeration Date
10/22/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
064-079 01 NC LICENSE
7804569 05 NC
institution
Provider Business Practice Location Address Details
Address
827 Evergreen Rd
City
State
Zip
27803-2426
Phone Number
252-446-8675
Fax Number
person
Provider Business Mailing Address Details
Address
827 Evergreen Rd
City
State
Zip
27803-2426
Phone Number
252-446-8675
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
License No.
064-079 (North Carolina)
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
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