Organization
RANDOLPH FELLOWSHIP HOME INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI B. BRADY (ADMINISTRATOR)
(336) 953-6222
Entity
Organization
Contact information
Practice address
373 HILL ST, ASHEBORO, NC 27203-5601
(336) 625-1637
(336) 625-0527
Mailing address
PO BOX 2543, ASHEBORO, NC 27204-2543
(336) 953-6222
(336) 625-0527
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
MHL076-001
NC
253Z00000X
In Home Supportive Care Agency
MHL076-007
NC
Other
Enumeration date
04/10/2014
Last updated
07/29/2015
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