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Organization
BYNUM'S-WAY ADOLESCENT TREATMENT HOME
Active
Organization
BYNUM'S-WAY ADOLESCENT TREATMENT HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LORA P BYNUM (CEO)
(336) 592-5625
Entity
Organization
Contact information
Practice address
4700 VIRGILINA RD, ROXBORO, NC 27574-8307
(336) 592-5625
(919) 550-2648
Mailing address
4700 VIRGILINA RD, ROXBORO, NC 27574-8307
(336) 592-5625
(919) 550-2648
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
073055
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
073055
MENTAL HEALTH LICENSE
NC
Enumeration date
07/15/2009
Last updated
07/15/2009
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