Organization
THE ROSSBERRY HOME OF FAIRMONT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GLORIA J ROSS RN (EXECUTIVE DIRECTOR)
(704) 933-3314
Entity
Organization
Contact information
Practice address
13178 NC HIGHWAY 130 E, FAIRMONT, NC 28340-9597
(910) 628-7575
(910) 628-7533
Mailing address
950 LANE ST, KANNAPOLIS, NC 28083-3748
(704) 933-3314
(704) 933-3320
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL078183
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603945
—
NC
Enumeration date
02/06/2007
Last updated
08/22/2020
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