Organization
CAROLINA RESIDENTIAL SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN M KINCAID (DIRECTOR)
(828) 572-2333
Entity
Organization
Contact information
Practice address
1691 OLD BUFFALO FORD RD, ASHEBORO, NC 27205-7893
(336) 879-8587
(336) 636-6403
Mailing address
PO BOX 286, RUTHERFORD COLLEGE, NC 28671-0286
(828) 572-2333
(980) 225-0500
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7804135
—
NC
Enumeration date
02/15/2007
Last updated
10/31/2009
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