Individual
KHRYSTARRA BAILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
813 N LEE ST, SALISBURY, NC 28144-3641
(704) 995-5402
Mailing address
813 N LEE ST, SALISBURY, NC 28144-3641
(704) 995-5402
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL080238
NC
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
MHL080238
NC
Other
Enumeration date
06/03/2024
Last updated
06/03/2024
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