Organization
THE GRAHAM HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DORIS FAIRCLOTH WELLS B.S. (OWNER)
(910) 592-8303
Entity
Organization
Contact information
Practice address
634 FOX RD, MARSTON, NC 28363-8522
(910) 557-3207
(910) 557-3207
Mailing address
501 MCKOY ST, CLINTON, NC 28328-2516
(910) 592-8303
(910) 557-3168
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL-077-048
NC
Other
Enumeration date
03/29/2007
Last updated
08/22/2020
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