Organization
FAITH HOME, INC.
Active
Parent organization
FAITH HOME, INC.
Other names
Faith Home
Organization subpart
Yes
Provider details
NPI number
Legal business name
FAITH HOME, INC.
Authorized official
MR. LEON HARLIE STURDIVANT SR. DIRECT OWNER (DO) (OWNER / DIRECTOR)
(336) 854-1718
Entity
Organization
Contact information
Practice address
808 MYSTIC DR, GREENSBORO, NC 27406-5726
(336) 856-0671
(336) 856-0671
Mailing address
2501 DONLORA DR, GREENSBORO, NC 27407-6015
(336) 854-1718
(336) 854-1718
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL041732
NC
Other
Enumeration date
02/29/2008
Last updated
04/07/2008
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