Organization
MY BROTHERS HOUSE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD TAYLOR (CEO)
(704) 532-4770
Entity
Organization
Contact information
Practice address
8525 WOOFFORD BRIDGE DRIVE, CHARLOTTE, NC 28216-6612
(704) 532-4770
Mailing address
4822 ALBEMARLE RD STE 105, CHARLOTTE, NC 28205-6612
(704) 532-4770
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
060467
NC
Other
Enumeration date
09/05/2007
Last updated
09/05/2007
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