Organization
MY BROTHERS HOUSE INC,
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD LEE TAYLOR (CEO)
(704) 532-4770
Entity
Organization
Contact information
Practice address
913 HIGHLAND MIST LN, CHARLOTTE, NC 28215-1548
(704) 532-4770
Mailing address
913 HIGHLAND MIST LN, CHARLOTTE, NC 28215-1548
(704) 532-4770
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL-060-538
NC
Other
Enumeration date
09/06/2007
Last updated
01/22/2008
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