House of Jabez LLC
NPI #1376757252 in Fremont, North Carolina
Provider Information
- NPI Number
- 1376757252
- Entity Type
- Organization
- Organization Name
- House of Jabez LLC
- Primary Specialty
- Community Based Residential Treatment Facility, Mental Illness
- Enumeration Date
- May 9, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 203 DOCK STREET
- City
- Fremont
- State
- North Carolina
- ZIP Code
- 27830-0662
- Phone
- (919) 242-1296
Authorized Official
- Name
- MR. CLYDE RANDOLPH WILKINS
- Title
- EXECUTIVE DIRECTOR
- Phone
- 19192426115
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community Based Residential Treatment Facility, Mental Illness |
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