# THE GRAHAM HOME

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

## Provider details

- **NPI number:** 1659491157
- **Authorized official:** MRS. DORIS FAIRCLOTH WELLS B.S. (OWNER)
- **Authorized official phone:** (910) 592-8303

## Contact information

- **Practice address:** 634 FOX RD, MARSTON, NC 28363-8522
- **Practice address phone:** (910) 557-3207
- **Practice address fax:** (910) 557-3207
- **Mailing address:** 501 MCKOY ST, CLINTON, NC 28328-2516
- **Mailing address phone:** (910) 592-8303
- **Mailing address fax:** (910) 557-3168

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | MHL-077-048 | NC | Yes |

## Other

- **Enumeration date:** 03/29/2007
- **Last updated:** 08/22/2020