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Organization
ALPHA DELTA FAMILY SERVICES GROUP, INC.
Active
Organization
ALPHA DELTA FAMILY SERVICES GROUP, INC.
Active
Other names
Jacobs Tree House
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRINA D TORAIN (QUALIFIED PROFESSIONAL)
(336) 562-5300
Entity
Organization
Contact information
Practice address
7612 N NC HIGHWAY 49, MEBANE, NC 27302-7519
(336) 562-5300
(336) 562-5500
Mailing address
7612 N NC HIGHWAY 49, MEBANE, NC 27302-7519
(336) 562-5300
(336) 562-5500
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-068-111
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603634
—
NC
Enumeration date
01/30/2007
Last updated
08/22/2020
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