NPI 1588707236

Carolina Residential Services, INC

Organisation Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Jacksonville, NC

Practice location

Address: 324 Pine Valley Rd, Jacksonville, NC 28546-7784
Phone: (910) 353-1415
Fax: (910) 353-1415
Mailing address: PO Box 286, Rutherford College, NC 28671-0286

Authorised official

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

Registered specialties (3)

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X Licence MHL-067-102 (NC)

Other Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in North Carolina →

Community/Behavioral Health Agency

Agencies Taxonomy 251S00000X

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Adult Care Home Facility

Nursing & Custodial Care Facilities Taxonomy 311ZA0620X

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Registry record

NPI: 1588707236
Entity type: Organization
NPI issued: 14 Feb 2007
Record last updated: 20 Jul 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.