# A SURE HOUSE, INC.

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

## Provider details

- **NPI number:** 1295887586
- **Authorized official:** MS. PAMELA LAVETTE PHILLIPS (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (336) 749-0264

## Contact information

- **Practice address:** 1265 ARBOR RD, WINSTON SALEM, NC 27104-1105
- **Practice address phone:** (336) 749-0264
- **Practice address fax:** (800) 314-7553
- **Mailing address:** 1265 ARBOR RD, WINSTON SALEM, NC 27104-1105
- **Mailing address phone:** (336) 749-0264
- **Mailing address fax:** (800) 314-7553

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | MHL-034-207 | NC | Yes |

## Other

- **Enumeration date:** 01/17/2007
- **Last updated:** 11/17/2011