Provider Demographics
NPI:1477698884
Name:LOVING CARE SUPERVISED LIVING GROUP
Entity Type:Organization
Organization Name:LOVING CARE SUPERVISED LIVING GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:BRINKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-937-3097
Mailing Address - Street 1:209 OVERTON DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-1748
Mailing Address - Country:US
Mailing Address - Phone:252-937-3097
Mailing Address - Fax:252-937-3096
Practice Address - Street 1:209 OVERTON DR
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-1748
Practice Address - Country:US
Practice Address - Phone:252-937-3097
Practice Address - Fax:252-937-3096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL064-052320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness