Organization
A SURE HOUSE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAMELA LAVETTE PHILLIPS (EXECUTIVE DIRECTOR)
(336) 749-0264
Entity
Organization
Contact information
Practice address
1265 ARBOR RD, WINSTON SALEM, NC 27104-1105
(336) 749-0264
(800) 314-7553
Mailing address
1265 ARBOR RD, WINSTON SALEM, NC 27104-1105
(336) 749-0264
(800) 314-7553
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-034-207
NC
Other
Enumeration date
01/17/2007
Last updated
11/17/2011
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