Individual provider · Type 1 NPI
Cynthia Maria Simon
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Jacksonville, NC
Practice location
507 Myna Dr
Jacksonville, NC 28540-6924
Mailing address
507 Myna Drive
Jacksonville, NC 28540
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary | 320900000X | MHL067128 (NC) |
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
Other intellectual and/or developmental disabilities community based residential treatment facility providers in Jacksonville
About NPI 1164630133
Cynthia Maria Simon's National Provider Identifier is 1164630133, issued on May 21, 2007. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Jacksonville, NC. The record was last updated on Jul 8, 2007.