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
933 W MAIN AVE, TAYLORSVILLE, NC 28681-2366
(828) 632-0790
(828) 635-5850
Mailing address
2037 CONNELLY SPRINGS RD, LENOIR, NC 28645-7830
(828) 572-2333
(980) 225-0500
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MHL-002-008
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301037S
—
NC
05
—
8303432S
—
NC
Enumeration date
02/14/2007
Last updated
02/22/2012
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