Organization
BLACKWELL'S COMMUNITY LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN BLACKWELL PP (OWNER)
(336) 317-1926
Entity
Organization
Contact information
Practice address
2406 ASHTON PARK LN, BURLINGTON, NC 27215-6310
(336) 317-1926
Mailing address
426 SOMERS AVE, BURLINGTON, NC 27215-2032
(336) 270-4463
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/04/2015
Last updated
08/04/2015
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