Supreme Love
NPI #1891922217 in Wilson, North Carolina
Provider Information
- NPI Number
- 1891922217
- Entity Type
- Organization
- Organization Name
- Supreme Love
- Primary Specialty
- Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Jun 11, 2009
- Last Updated
- Jun 11, 2009
Practice Location
- Address
- 4232 COGHILL DR N
- City
- Wilson
- State
- North Carolina
- ZIP Code
- 27896-9503
- Phone
- (252) 234-6163
Authorized Official
- Name
- BETTY FORSYTHE
- Title
- OWNER
- Phone
- (252) 234-6163
Specialties & Taxonomy Codes
| Specialty |
|---|
| Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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