# ALPHA DELTA FAMILY SERVICES GROUP, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Jacobs Tree House
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982740205
- **Authorized official:** MRS. TRINA D TORAIN (QUALIFIED PROFESSIONAL)
- **Authorized official phone:** (336) 562-5300

## Contact information

- **Practice address:** 7612 N NC HIGHWAY 49, MEBANE, NC 27302-7519
- **Practice address phone:** (336) 562-5300
- **Practice address fax:** (336) 562-5500
- **Mailing address:** 7612 N NC HIGHWAY 49, MEBANE, NC 27302-7519
- **Mailing address phone:** (336) 562-5300
- **Mailing address fax:** (336) 562-5500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | MHL-068-111 | NC | Yes |

## Other

- **Enumeration date:** 01/30/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 6603634 | — | NC |