# PINEBROOK RESIDENTIAL CENTER 2

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

## Provider details

- **NPI number:** 1740315837
- **Authorized official:** MR. FRED H. LEONARD MS, LPC, NC LIC. ADM (PRESIDENT)
- **Authorized official phone:** (336) 679-8671

## Contact information

- **Practice address:** 244 HARRISON AVE, YADKINVILLE, NC 27055-8246
- **Practice address phone:** (336) 679-8671
- **Practice address fax:** (336) 679-7500
- **Mailing address:** PO BOX 760, YADKINVILLE, NC 27055-0760
- **Mailing address phone:** (336) 679-8671
- **Mailing address fax:** (336) 679-7500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | HAL-099-010 | NC | Yes |

## Other

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