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Organization
NORTH CAROLINA CHILDREN'S PLACE, INC
Active
Organization
NORTH CAROLINA CHILDREN'S PLACE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALICIA Y CLODFELTER (VICE PRESIDENT)
(336) 449-9775
Entity
Organization
Contact information
Practice address
504 SUNNYBROOK DR, MONROE, NC 28110-2719
(336) 449-9775
Mailing address
603 GREYROCK RD, WHITSETT, NC 27377-9225
(336) 449-9775
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-090-135
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603342
—
NC
Enumeration date
11/13/2007
Last updated
11/19/2007
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