Organization
JOSHUA'S HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VICTORIA JACKSON (ADMINISTRATOR)
(336) 995-5219
Entity
Organization
Contact information
Practice address
139 OAKRIDGE LN, MOCKSVILLE, NC 27028-5663
(336) 492-7033
(336) 492-7033
Mailing address
139 OAKRIDGE LANE, MOCKSVILLE, NC 27028-5663
(336) 492-7033
(336) 492-7033
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
MHL-030-027
NC
Other
Enumeration date
12/31/2007
Last updated
12/31/2007
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