Organization
MELROSE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MELODY ROSE JOHNSON (CEO)
(910) 536-2253
Entity
Organization
Contact information
Practice address
421 MAIDEN LN STE 207, FAYETTEVILLE, NC 28301-5055
(910) 536-2253
Mailing address
421 MAIDEN LN, SUITE 207, FAYETTEVILLE, NC 28301-5055
(910) 536-2256
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/14/2008
Last updated
12/27/2008
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