Organization
FRESH START SERVICE SUPPORT
Active
Other names
Kelsey Homes
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHRISTAL SMITH (ADMINISTRATOR, PARAPROFESSIONAL)
(336) 988-7339
Entity
Organization
Contact information
Practice address
4708 MEADOWCROFT RD, GREENSBORO, NC 27406-8085
(336) 988-7339
Mailing address
4708 MEADOWCROFT RD, GREENSBORO, NC 27406-8085
(336) 988-7339
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-041-907
NC
Other
Enumeration date
06/15/2009
Last updated
06/15/2009
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