| Queens Group Home | |
|
601 Eastern Ave Rocky Mount NC 27801-5856 | |
| (919) 247-2312 | |
| (919) 329-7640 |
| Full Name | Queens Group Home |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 601 Eastern Ave, Rocky Mount, North Carolina |
| Authorized Official Name and Position | Ekelekamchukwu Alphonsus Ngwadom (CEO) |
| Authorized Official Contact | 9192472312 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Queens Group Home 295 Adams Point Dr Garner NC 27529-6507 Ph: (919) 247-2312 | Queens Group Home 601 Eastern Ave Rocky Mount NC 27801-5856 Ph: (919) 247-2312 |
| NPI Number | 1780295055 |
|---|---|
| Provider Enumeration Date | 08/11/2020 |
| Last Update Date | 04/02/2023 |
| Certification Date | 04/02/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780295055 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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