Organization
FOKUS RESIDENTIAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEITH DERRICK HAITH BS (DIRECTOR)
(336) 675-4713
Entity
Organization
Contact information
Practice address
411 TILLMAN ST, BURLINGTON, NC 27217-2358
(336) 350-8420
Mailing address
3116 JUNIPER DR, BURLINGTON, NC 27215-7934
(336) 270-6004
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
001-235
NC
Other
Enumeration date
01/23/2015
Last updated
01/23/2015
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