# BLACKWELL'S COMMUNITY LIVING LLC

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

## Provider details

- **NPI number:** 1346571304
- **Authorized official:** ROBIN BLACKWELL (DIRECTOR)
- **Authorized official phone:** (336) 317-1926

## Contact information

- **Practice address:** 426 SOMERS AVE, BURLINGTON, NC 27215-2032
- **Practice address phone:** (336) 317-1926
- **Practice address fax:** (336) 674-6190
- **Mailing address:** 426 SOMERS AVE, BURLINGTON, NC 27215-2032
- **Mailing address phone:** (336) 317-1926
- **Mailing address fax:** (336) 674-6190

## Taxonomy

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

## Other

- **Enumeration date:** 01/14/2010
- **Last updated:** 07/21/2022