# NAZARETH CHILDREN'S HOME

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

## Provider details

- **NPI number:** 1710294012
- **Authorized official:** MR. RONNIE DONNELL GLOVER MSW, P-LCSW (CLINICAL SOCIAL WORKER)
- **Authorized official phone:** (704) 279-5556

## Contact information

- **Practice address:** 725 CRESCENT ROAD, NAZARETH CHILDREN'S HOME, ROCKWELL, NC 28138
- **Practice address phone:** (704) 279-5556
- **Mailing address:** P.O.BOX 1438, NAZARETH CHILDREN'S HOME, ROCKWELL, NC 28138
- **Mailing address phone:** (704) 279-5556

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | P005001 | NC | Yes |

## Other

- **Enumeration date:** 09/08/2010
- **Last updated:** 09/08/2010