Organization
SHEKINAH RESOURCE FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN A. SMITH (CEO)
(336) 747-3479
Entity
Organization
Contact information
Practice address
301 S OAKLAND AVE, UNIT 6444, STATESVILLE, NC 28687-0837
(336) 747-3479
Mailing address
450 W HANES MILL RD, 222, WINSTON SALEM, NC 27105-9141
(336) 747-3479
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
27780134
NC
385HR2050X
Respite Care Camp
Primary
27780134
NC
Other
Enumeration date
11/21/2016
Last updated
11/21/2016
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