Organization
CAROLINA RESIDENTIAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN M KINCAID (DIRECTOR/OWNER)
(828) 413-3786
Entity
Organization
Contact information
Practice address
307 GIDDENS ST, CLINTON, NC 28328-3413
(910) 299-5032
(910) 299-5033
Mailing address
PO BOX 286, RUTHERFORD COLLEGE, NC 28671-0286
(828) 572-2333
(980) 225-0500
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MHL-082-007
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8303426S
—
NC
Enumeration date
03/12/2012
Last updated
03/12/2012
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