Organization
CAROLINA RESIDENTIAL SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN M KINCAID (DIRECTOR)
(828) 572-2333
Entity
Organization
Contact information
Practice address
112 CHERRY STREET, WOODLAND, NC 27897-0717
(252) 587-3276
(252) 587-3278
Mailing address
PO BOX 286, RUTHERFORD COLLEGE, NC 28671-0286
(828) 572-2333
(980) 225-0385
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
MHL-066-003
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7804229
—
NC
Enumeration date
02/14/2007
Last updated
11/01/2009
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