Organization
BLANTON HOME II INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. IVA BLANTON (OWNER OPERATOR)
(704) 481-8054
Entity
Organization
Contact information
Practice address
2650 S LAFAYETTE ST, SHELBY, NC 28152-7583
(704) 481-8054
(704) 480-7628
Mailing address
2650 S LAFAYETTE ST, SHELBY, NC 28152-7583
(704) 481-8054
(704) 480-7628
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL-023-079
NC
Other
Enumeration date
12/29/2006
Last updated
08/22/2020
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