Organization
BRUSHY MOUNTAIN GROUP HOMES, INC.
Active
Other names
Mulberry Group Home
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHELLEY DARLENE GAMBLE (EXECUTIVE DIRECTOR)
(336) 838-3789
Entity
Organization
Contact information
Practice address
1904 WINDY RIDGE RD, NORTH WILKESBORO, NC 28659-8752
(336) 670-2265
(336) 838-3490
Mailing address
PO BOX 1045, NORTH WILKESBORO, NC 28659-1045
(336) 838-3789
(336) 838-3490
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL097044
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7804484
—
NC
Enumeration date
08/18/2006
Last updated
06/19/2008
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