# FALCON CREST RESIDENTIAL CARE

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

## Provider details

- **NPI number:** 1104944081
- **Authorized official:** MS. WENDY KAY BRADSHER (ADM. MANAGER/OWNER)
- **Authorized official phone:** (336) 226-2575

## Contact information

- **Practice address:** 1101 S FIFTH ST, MEBANE, NC 27302-9182
- **Practice address phone:** (336) 226-2575
- **Practice address fax:** (336) 226-2474
- **Mailing address:** 1101 SOUTH FIFTH STREET, MEBANE, NC 27302-1101
- **Mailing address phone:** (336) 226-2575
- **Mailing address fax:** (336) 226-2474

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | 753096607 | NC | — |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | MHL-001-103 | NC | Yes |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | MHL-001-141 | NC | — |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | MHL-001-103 | NC | — |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | MHL-001-141 | NC | — |

## Other

- **Enumeration date:** 03/27/2007
- **Last updated:** 08/21/2013