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Organization
ROSE OF SHARON ADOLESCENT TREATMENT HOME
Active
Organization
ROSE OF SHARON ADOLESCENT TREATMENT HOME
Active
Parent organization
ROSE OF SHARON ADOLESCENT TREATMENT HOME
Organization subpart
Yes
Provider details
NPI number
Legal business name
ROSE OF SHARON ADOLESCENT TREATMENT HOME
Authorized official
MRS. SHARON W PETTIFORD (CEO-OWNER)
(919) 550-2648
Entity
Organization
Contact information
Practice address
13 RHYN CT, DURHAM, NC 27704-2359
(919) 220-2492
(919) 550-2648
Mailing address
161 KENTUCKY DERBY DR, CLAYTON, NC 27520-6080
(919) 550-2648
(919) 220-1185
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL 032275
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603291
—
NC
Enumeration date
01/27/2007
Last updated
06/16/2008
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