Organization
KD SUPPORT SERVICES
Active
Other names
Kellys Care 7
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH DELLINGER BS;QP (DIRECTOR OF OPERATIONS)
(828) 245-4011
Entity
Organization
Contact information
Practice address
1998 HARRIS HENRIETTA RD, MOORESBORO, NC 28114-8209
(828) 657-4757
(828) 245-4099
Mailing address
158 US HIGHWAY 221A, FOREST CITY, NC 28043-5600
(828) 245-4011
(828) 245-4099
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL-081-104
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3418462
—
NC
Enumeration date
02/18/2016
Last updated
02/18/2016
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