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
5118 FOXVIEW DR, PLEASANT GARDEN, NC 27313-9572
(336) 674-3464
Mailing address
426 SOMERS AVE, BURLINGTON, NC 27215-2032
(336) 270-4463
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/03/2015
Last updated
08/03/2015
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