Organization
A PLACE OF THEIR OWN,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS CHANISTY H MITCHELL (DIRECTOR)
(336) 382-0178
Entity
Organization
Contact information
Practice address
5629 BURLINGTON RD, 1525 BOWMORE PLACE, MC LEANSVILLE, NC 27301-9209
(336) 382-0178
Mailing address
5629 BURLINGTON RD, 1525 BOWMORE PLACE, MC LEANSVILLE, NC 27301-9209
(336) 382-0178
(336) 697-7484
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
MHL-041-852
NC
Other
Enumeration date
06/08/2007
Last updated
08/17/2020
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