Organization
CAROLINA MOUNTAIN DDA GROUP HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MILDRED L REECE (PRESIDENT)
(828) 665-6578
Entity
Organization
Contact information
Practice address
82 DANIEL RIDGE ROAD, CANDLER, NC 28715
(828) 665-6578
Mailing address
PO BOX 1311, CANDLER, NC 28715-1311
(828) 665-6578
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
MHL-011-229
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7804613
—
NC
Enumeration date
06/20/2007
Last updated
08/22/2020
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