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Spirit Of Excellence Community Outreach, Inc
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Jacksonville, North Carolina
NPI 1508291683

Spirit Of Excellence Community Outreach, Inc is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Jacksonville, NC. Spirit Of Excellence Community Outreach, Inc practices in Jacksonville, NC. The NPI Number for Spirit Of Excellence Community Outreach, Inc is 1508291683 and holds a License No. (North Carolina).

The current practice location address for Spirit Of Excellence Community Outreach, Inc is 510 Crissy Dr, Jacksonville, NC and can be reached out via phone at 910-219-0459.

Location: 510 Crissy Dr, Jacksonville, NC, 28541-0752
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1508291683
Provider Name
Spirit Of Excellence Community Outreach, Inc
Credential
Provider Entity Type
Organization
Address
510 Crissy Dr, Jacksonville, NC, 28541-0752
Phone Number
910-219-0459
Fax Number
Provider Enumeration Date
09/09/2013
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
3418119 05 NC
institution
Provider Business Practice Location Address Details
Address
510 Crissy Dr
City
Jacksonville
State
North Carolina
Zip
28540-9183
Phone Number
910-219-0459
Fax Number
person
Provider Business Mailing Address Details
Address
510 Crissy Dr
City
Jacksonville
State
North Carolina
Zip
28540-9183
Phone Number
910-219-0459
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Mental Illness
Speciality
-
Taxonomy
320800000X
License No.
MHL-067-157 (North Carolina)
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
person
Provider's Taxonomy Details 2
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
(North Carolina)
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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