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Organization

TRAILS CAROLINA LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. GRAHAM SHANNONHOUSE (EXECUTIVE DIRECTOR)
(828) 885-5920
Entity
Organization

Contact information

Practice address
500 WINDING GAP RD, LAKE TOXAWAY, NC 28747-8786
(828) 885-5920
(828) 885-5922
Mailing address
500 WINDING GAP RD, LAKE TOXAWAY, NC 28747-8786
(828) 885-5920
(828) 885-5922

Taxonomy

Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
27G.5200
NC

Other

Enumeration date
05/28/2014
Last updated
05/28/2014
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