Organization
CEESONS OF CHANGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TYSON RULON FEARRINGTON (DIRECTOR/OWNER)
(336) 684-4493
Entity
Organization
Contact information
Practice address
614 OAKDALE CT, BURLINGTON, NC 27217-1724
(336) 270-5030
(336) 270-5030
Mailing address
614 OAKDALE CT, BURLINGTON, NC 27217-1724
(336) 270-5030
(336) 270-5030
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
320800000X
NC
Other
Enumeration date
12/09/2009
Last updated
12/09/2009
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