Organization
FALCON CREST RESIDENTIAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY KAY BRADSHER (ADMINISTRATOR MANAGER)
(336) 226-2575
Entity
Organization
Contact information
Practice address
2094 HAITH-FULLER TRAIL, MEBANE, NC 27302
(336) 226-2575
(336) 226-2474
Mailing address
1101 S FIFTH ST, PO BOX 1670, MEBANE, NC 27302-9182
(336) 226-2575
(336) 226-2474
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
MHL-001-141
NC
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
MHL-001-141
NC
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
MHL-001-141
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603998
—
NC
Enumeration date
06/13/2013
Last updated
05/14/2018
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