Organization
CAROLINA RESIDENTIAL SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN KINCAID (DIRECTOR)
(828) 572-2333
Entity
Organization
Contact information
Practice address
144-B COMMUNITY COLLEGE ROAD, AHOSKIE, NC 27910-8047
(252) 332-8553
(252) 332-8553
Mailing address
PO BOX 286, RUTHERFORD COLLEGE, NC 28671-0286
(828) 572-2333
(980) 225-0500
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MHL-046-023
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8300936S
—
NC
Enumeration date
02/14/2007
Last updated
10/31/2009
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