Organization
HOUSE OF JEWELS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENITA DOUGLAS (DIRECTOR OF OPERATIONS)
(704) 214-1174
Entity
Organization
Contact information
Practice address
107 ROBINSON DR, CHERRYVILLE, NC 28021-8100
(704) 214-1174
Mailing address
100 BLACK ELK LN, BLYTHEWOOD, SC 29016-7220
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
07/29/2019
Last updated
07/29/2019
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