Organization
YADKIN HOME PLACE SIX INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY CARLTON (PRESIDENT)
(336) 679-8201
Entity
Organization
Contact information
Practice address
160 RIVER RD, BOONVILLE, NC 27011-8338
(336) 551-4045
Mailing address
PO BOX 1723, YADKINVILLE, NC 27055-1723
(336) 679-8201
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
MHL-099-027
NC
Other
Enumeration date
09/22/2012
Last updated
09/22/2012
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