Provider Demographics
NPI:1073766820
Name:A GREATER POWER WITH INN
Entity Type:Organization
Organization Name:A GREATER POWER WITH INN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:WILHELMENIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEBRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-459-8777
Mailing Address - Street 1:3784 OLD COUNTY HOME RD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27856-8992
Mailing Address - Country:US
Mailing Address - Phone:252-459-8777
Mailing Address - Fax:
Practice Address - Street 1:3784 OLD COUNTY HOME RD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:NC
Practice Address - Zip Code:27856-8992
Practice Address - Country:US
Practice Address - Phone:252-459-8777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-24
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-064-094322D00000X
322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children