# TRAILS CAROLINA LLC

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

## Provider details

- **NPI number:** 1831501675
- **Authorized official:** MS. GRAHAM SHANNONHOUSE (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (828) 885-5920

## Contact information

- **Practice address:** 500 WINDING GAP RD, LAKE TOXAWAY, NC 28747-8786
- **Practice address phone:** (828) 885-5920
- **Practice address fax:** (828) 885-5922
- **Mailing address:** 500 WINDING GAP RD, LAKE TOXAWAY, NC 28747-8786
- **Mailing address phone:** (828) 885-5920
- **Mailing address fax:** (828) 885-5922

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | 27G.5200 | NC | Yes |

## Other

- **Enumeration date:** 05/28/2014
- **Last updated:** 05/28/2014