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Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DONNA IRELAND-MCNEIL (PRESIDENT)
(336) 512-0638
Entity
Organization

Contact information

Practice address
1010 MADISON ST, BURLINGTON, NC 27217-1435
(336) 570-7008
(336) 570-7008
Mailing address
109 STAGG ST, BURLINGTON, NC 27217-2653
(336) 229-5072
(336) 570-7008

Taxonomy

Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
MHL001145
NC

Other

Enumeration date
04/17/2007
Last updated
08/22/2020
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