# BEROS ENTERPRISE LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** BEROS ENTERPRISE LLC
- **Other names:** Ebenezer House
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1578743795
- **Legal business name:** BEROS ENTERPRISE LLC
- **Authorized official:** MRS. BEVERLIE ROSE GRIZZLE DIRECT OWNER (HABTECHICAN)
- **Authorized official phone:** (336) 491-7190

## Contact information

- **Practice address:** 5331 STIGALL RD, KERNERSVILLE, NC 27284-7673
- **Practice address phone:** (336) 491-7190
- **Practice address fax:** (336) 510-7490
- **Mailing address:** 5331 STIGALL RD, KERNERSVILLE, NC 27284-7673
- **Mailing address phone:** (336) 491-7190
- **Mailing address fax:** (336) 510-7490

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | MHL-034-218 | NC | Yes |

## Other

- **Enumeration date:** 11/05/2007
- **Last updated:** 08/25/2009