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Organization

MY BROTHERS HOUSE INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RICHARD TAYLOR (CEO)
(704) 532-4770
Entity
Organization

Contact information

Practice address
4822 ALBEMARLE RD STE 105, CHARLOTTE, NC 28205-6612
(704) 532-4770
(704) 532-4774
Mailing address
4822 ALBEMARLE RD, SUITE 105, CHARLOTTE, NC 28205-6668
(704) 532-4770

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
320800000X
Mental Illness Community Based Residential Treatment Facility
323P00000X
Psychiatric Residential Treatment Facility
060-467
NC
323P00000X
Psychiatric Residential Treatment Facility
060-538
NC
323P00000X
Psychiatric Residential Treatment Facility
060-757
NC
323P00000X
Psychiatric Residential Treatment Facility
Primary
092-519
NC

Other

Enumeration date
02/13/2007
Last updated
07/03/2019
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