# MY BROTHERS HOUSE INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063606861
- **Authorized official:** RICHARD TAYLOR (CEO)
- **Authorized official phone:** (704) 532-4770

## Contact information

- **Practice address:** 8525 WOOFFORD BRIDGE DRIVE, CHARLOTTE, NC 28216-6612
- **Practice address phone:** (704) 532-4770
- **Mailing address:** 4822 ALBEMARLE RD STE 105, CHARLOTTE, NC 28205-6612
- **Mailing address phone:** (704) 532-4770

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 323P00000X | Psychiatric Residential Treatment Facility | 060467 | NC | Yes |

## Other

- **Enumeration date:** 09/05/2007
- **Last updated:** 09/05/2007