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Organization
BLC GROUP HOME LLC
Active
Organization
BLC GROUP HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NAPHASORN REYES (OWNER)
(641) 426-3956
Entity
Organization
Contact information
Practice address
5720 SCARECROW CT, FAYETTEVILLE, NC 28314-8560
(641) 426-3956
Mailing address
5720 SCARECROW CT, FAYETTEVILLE, NC 28314-8560
(641) 426-3956
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
323P00000X
Psychiatric Residential Treatment Facility
—
—
Other
Enumeration date
06/24/2025
Last updated
06/24/2025
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