Organization
BAPTIST HOUSE AT BETHABARA
Active
Other names
Baptist Children's Homes of NC, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. C. F. MCDOWELL III (EXECUTIVE VICE PRESIDENT)
(336) 474-1260
Entity
Organization
Contact information
Practice address
4643 OLD TOWN DR, WINSTON SALEM, NC 27106-2616
(336) 727-1973
(336) 727-1547
Mailing address
PO BOX 338, THOMASVILLE, NC 27361-0338
(336) 474-1260
(336) 472-8157
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
FCA034057
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7804105
—
NC
Enumeration date
02/21/2007
Last updated
08/22/2020
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