Organization
THE CHILDREN'S HOME
Active
Other names
Epworth Cottage
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE M BRYAN JR. (CEO)
(336) 721-7600
Entity
Organization
Contact information
Practice address
1001 REYNOLDA RD, WINSTON SALEM, NC 27104-3245
(336) 721-7600
(336) 728-4355
Mailing address
1001 REYNOLDA RD, WINSTON SALEM, NC 27104-3245
(336) 721-7600
(336) 728-4355
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL034165
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603449
—
NC
Enumeration date
12/13/2006
Last updated
08/22/2020
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