| Mutty Group Home | |
|
254 Ashfield Ln Lexington NC 27292-8348 | |
| (860) 986-0003 | |
| Not Available |
| Full Name | Mutty Group Home |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 254 Ashfield Ln, Lexington, North Carolina |
| Authorized Official Name and Position | Mutiat B Bamgbala (OWNER) |
| Authorized Official Contact | 8609860003 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mutty Group Home 254 Ashfield Ln Lexington NC 27292-8348 Ph: (860) 986-0003 | Mutty Group Home 254 Ashfield Ln Lexington NC 27292-8348 Ph: (860) 986-0003 |
| NPI Number | 1477334316 |
|---|---|
| Provider Enumeration Date | 10/06/2023 |
| Last Update Date | 10/06/2023 |
| Certification Date | 10/06/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477334316 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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