Evergreen Road Facility
NPI #1043409584 in Rocky Mount, North Carolina
Provider Information
- NPI Number
- 1043409584
- Entity Type
- Organization
- Organization Name
- Evergreen Road Facility
- Primary Specialty
- Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Oct 22, 2007
- Last Updated
- Oct 22, 2007
Practice Location
- Address
- 827 EVERGREEN RD
- City
- Rocky Mount
- State
- North Carolina
- ZIP Code
- 27803-2426
- Phone
- (252) 446-8675
Authorized Official
- Name
- MR. DUANE BRICKHOUSE
- Title
- CONTROLLER
- Phone
- (410) 910-1489
Specialties & Taxonomy Codes
| Specialty |
|---|
| Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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