# BRUSHY MOUNTAIN GROUP HOMES, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Swain Street Group Home
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104939313
- **Authorized official:** MRS. SHELLEY DARLENE GAMBLE (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (336) 838-3789

## Contact information

- **Practice address:** 1224 SWAIN ST, NORTH WILKESBORO, NC 28659-3343
- **Practice address phone:** (336) 838-7220
- **Practice address fax:** (336) 838-3490
- **Mailing address:** PO BOX 1045, NORTH WILKESBORO, NC 28659-1045
- **Mailing address phone:** (336) 838-3789
- **Mailing address fax:** (336) 838-3490

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | MHL097046 | NC | Yes |

## Other

- **Enumeration date:** 08/15/2006
- **Last updated:** 06/19/2008