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Carolina Residential Services, Inc

Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Mount Airy, NC

NPI 1700929445 · NPPES record last updated Jul 20, 2013

Key facts

NPI
1700929445
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
License
MHL-086-037 (NC)
Legal business name
CAROLINA RESIDENTIAL SERVICES, INC
Practice address
910 Spring St
Mount Airy, NC 27030-5512
Phone
(336) 786-8032
Fax
(336) 786-8032
NPI assigned
Feb 14, 2007
Organization subpart
No

Authorized official

Name
Ms. Susan M Kincaid
Title
Director
Phone
(828) 572-2333

Corporate family (same tax ID) 41

Organizations that report the same tax identification number in the National Provider Directory.

View all 41

National Provider Directory

Tax ID family
Carolina Residential Services Inc (42 organizations share this tax ID)

Locations

910 Spring St
Mount Airy, NC 27030
Phone (336) 786-8032

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Adult Care Home Facility 311ZA0620X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X MHL-086-037 NC Yes

Addresses

Primary practice location

910 Spring St
Mount Airy, NC 27030-5512

Mailing address

PO Box 286
Rutherford College, NC 28671-0286
Phone (828) 572-2333

Other identifiers

IdentifierTypeStateIssuer
7805082MedicaidNC
7806595MedicaidNC

Other providers in Mount Airy, NC

All providers in Mount Airy, NC · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in North Carolina

Sources for this page

Verify at the official NPI Registry.