# NAZARETH CHILDRENS HOME

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

## Provider details

- **NPI number:** 1568622249
- **Authorized official:** MS. JACQUELINE LEIGH MILLICAN (AVP OF FOSTER CARE SERVICES)
- **Authorized official phone:** (704) 279-5556

## Contact information

- **Practice address:** 7920 RED ROAD, ROCKWELL, NC 28138
- **Practice address phone:** (704) 279-5556
- **Practice address fax:** (704) 279-5439
- **Mailing address:** PO BOX 1438, ROCKWELL, NC 28138-1438
- **Mailing address phone:** (704) 279-5556
- **Mailing address fax:** (704) 279-5439

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | MHL080173 | NC | Yes |

## Other

- **Enumeration date:** 06/16/2008
- **Last updated:** 06/16/2008