# EBENEZER CHRISTIAN CHILDRENS HOME

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ebenezer Garden Christian Childrens Home
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881866002
- **Authorized official:** MRS. JEAN DAVIS (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (336) 667-5683

## Contact information

- **Practice address:** 1006 BYRD RIDGE RD, NORTH WILKESBORO, NC 28659-8044
- **Practice address phone:** (336) 667-5683
- **Practice address fax:** (336) 667-8634
- **Mailing address:** P.O. BOX 2777, NORTH WILKESBORO, NC 28659-2777
- **Mailing address phone:** (336) 667-5683
- **Mailing address fax:** (336) 667-8634

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | MHL-097-061 | NC | Yes |

## Other

- **Enumeration date:** 03/27/2008
- **Last updated:** 03/27/2008