Provider Demographics
NPI:1992910434
Name:SARAH'S PLACE
Entity type:Organization
Organization Name:SARAH'S PLACE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GOLDIE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:GILMORE
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:252-532-5554
Mailing Address - Street 1:9 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:WELDON
Mailing Address - State:NC
Mailing Address - Zip Code:27890-1650
Mailing Address - Country:US
Mailing Address - Phone:252-536-2290
Mailing Address - Fax:252-536-2062
Practice Address - Street 1:9 E 6TH ST
Practice Address - Street 2:
Practice Address - City:WELDON
Practice Address - State:NC
Practice Address - Zip Code:27890-1650
Practice Address - Country:US
Practice Address - Phone:252-536-2290
Practice Address - Fax:252-536-2062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-042-045320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities