Organization
HEAVENLY TOUCH RESIDENTIAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIJUANA HAIRSTON (CEO)
(704) 635-3015
Entity
Organization
Contact information
Practice address
4720 BAILEYS LAKE RD NW APT 204, CONCORD, NC 28027-8576
(704) 635-3015
Mailing address
4720 BAILEYS LAKE RD NW APT 204, CONCORD, NC 28027-8576
(704) 635-3015
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/28/2019
Last updated
07/28/2019
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