# MY BROTHERS HOUSE INC,

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

## Provider details

- **NPI number:** 1225223969
- **Authorized official:** RICHARD LEE TAYLOR (CEO)
- **Authorized official phone:** (704) 532-4770

## Contact information

- **Practice address:** 913 HIGHLAND MIST LN, CHARLOTTE, NC 28215-1548
- **Practice address phone:** (704) 532-4770
- **Mailing address:** 913 HIGHLAND MIST LN, CHARLOTTE, NC 28215-1548
- **Mailing address phone:** (704) 532-4770

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | MHL-060-538 | NC | Yes |

## Other

- **Enumeration date:** 09/06/2007
- **Last updated:** 01/22/2008