# CAROLINA MOUNTAIN DDA GROUP HOME

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

## Provider details

- **NPI number:** 1679778310
- **Authorized official:** MS. MILDRED L REECE (PRESIDENT)
- **Authorized official phone:** (828) 665-6578

## Contact information

- **Practice address:** 82 DANIEL RIDGE ROAD, CANDLER, NC 28715
- **Practice address phone:** (828) 665-6578
- **Mailing address:** PO BOX 1311, CANDLER, NC 28715-1311
- **Mailing address phone:** (828) 665-6578

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | MHL-011-229 | NC | Yes |

## Other

- **Enumeration date:** 06/20/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7804613 | — | NC |