Organization
PHILLIPS RESIDENTIAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RENNARD NONE HARRIS MS (OWNER)
(404) 423-3129
Entity
Organization
Contact information
Practice address
305 THURSTON DR W, WILSON, NC 27893-2854
(404) 423-3129
Mailing address
PO BOX 1391, WILSON, NC 27894-1391
(404) 423-3129
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-098-131
NC
Other
Enumeration date
05/28/2009
Last updated
05/28/2009
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