Organization
CAROLINA RESIDENTIAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEREK WILSON (DIRECTOR OF OPERATIONS)
(919) 662-7873
Entity
Organization
Contact information
Practice address
641 W MAIN AVE, TAYLORSVILLE, NC 28681-2327
(828) 632-0790
(828) 635-5850
Mailing address
1202 BENSON RD, GARNER, NC 27529-4648
(919) 662-7873
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301658B
—
NC
Enumeration date
03/12/2007
Last updated
09/11/2025
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