Organization
PINEBROOK RESIDENTIAL CENTER 1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FRED H. LEONARD MS, LPC, NC LIC. ADM (PRESIDENT)
(828) 655-3222
Entity
Organization
Contact information
Practice address
312 HARRISON AVE, YADKINVILLE, NC 27055-8247
(828) 655-3222
(336) 679-7500
Mailing address
PO BOX 760, YADKINVILLE, NC 27055-0760
(828) 655-3222
(336) 679-7500
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
HAL-099-009
NC
Other
Enumeration date
02/21/2007
Last updated
05/06/2016
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