Organization
CORBIN HOUSE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DONNA HINES MINOR (EXECUTIVE DIRECTOR)
(336) 749-0900
Entity
Organization
Contact information
Practice address
400 CORBIN ST, WINSTON SALEM, NC 27107-1960
(336) 771-3122
Mailing address
PO BOX 107, BETHANIA, NC 27010-0107
(336) 771-3122
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
MHL034187
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603943
—
NC
Enumeration date
11/08/2006
Last updated
08/22/2020
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