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Organization
SHUFFORD GROUP HOME
Active
Organization
SHUFFORD GROUP HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNETTE LASHONDA SHUFFORD (OWNER)
(919) 986-0053
Entity
Organization
Contact information
Practice address
5164 LIMEWOOD ST, KNIGHTDALE, NC 27545-8138
(919) 986-0053
(919) 231-0426
Mailing address
2905 DEEDA CT, RALEIGH, NC 27610-5461
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
MHL-092-709
NC
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-092-709
NC
Other
Enumeration date
06/03/2008
Last updated
06/19/2008
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