Organization
REALISTIC CHANGE BY C.H.O.I.C.E. @ WINCHESTER I
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RHONDA CORPENING MSW (CLINICAL DIRECTOR, C.E.O.)
(704) 528-2044
Entity
Organization
Contact information
Practice address
332 WINCHESTER RD, TROUTMAN, NC 28166-9644
(704) 528-2044
(704) 528-2077
Mailing address
PO BOX 570, TROUTMAN, NC 28166-0570
(704) 528-2044
(704) 528-2077
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
MHL 049-131
NC
Other
Enumeration date
09/01/2011
Last updated
06/20/2018
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