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Organization

GRANDMA'S HOUSE OF MEBANE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LINA JOHNSON (OWNER)
(336) 350-3557
Entity
Organization

Contact information

Practice address
421 LANCASTER RD, MEBANE, NC 27302-7568
(336) 350-3557
Mailing address
421 LANCASTER RD, MEBANE, NC 27302-7568
(336) 350-3557

Taxonomy

Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
NC

Other

Enumeration date
03/18/2009
Last updated
07/21/2022
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