# GILL HOUSE

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

## Provider details

- **NPI number:** 1639205701
- **Authorized official:** MRS. CARDRIENNE GILL (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (919) 828-5339

## Contact information

- **Practice address:** 845 CROSS LINK RD, RALEIGH, NC 27610-4730
- **Practice address phone:** (919) 755-0791
- **Practice address fax:** (919) 755-0355
- **Mailing address:** 1412 GRIFFIN CIR, RALEIGH, NC 27610-4928
- **Mailing address phone:** (919) 828-5339
- **Mailing address fax:** (919) 755-0355

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | MHL092590 | NC | Yes |

## Other

- **Enumeration date:** 02/26/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 6603754 | — | NC |