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Organization
FRESH START SERVICE SUPPORT
Active
Organization
FRESH START SERVICE SUPPORT
Active
Other names
Kelsey Homes
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHRISTAL SMITH (ADMINISTRATOR, PARAPROFESSIONAL)
(336) 988-7339
Entity
Organization
Contact information
Practice address
4708 MEADOWCROFT RD, GREENSBORO, NC 27406-8085
(336) 988-7339
Mailing address
4708 MEADOWCROFT RD, GREENSBORO, NC 27406-8085
(336) 988-7339
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-041-907
NC
Other
Enumeration date
06/15/2009
Last updated
06/15/2009
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