Organization
THE MENTAL HEALTH ASSOCIATION IN NORTH CAROLINA, INC.
Active
Other names
Willow Place Group Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN COCHRAN (FINANCIAL ASSISTANT)
(919) 866-3287
Entity
Organization
Contact information
Practice address
603 LONG ST, WEST JEFFERSON, NC 28694-8810
(336) 246-6504
Mailing address
1331 SUNDAY DR, RALEIGH, NC 27607
(919) 866-3287
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
MHL-005-008
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7804245
—
NC
Enumeration date
04/10/2007
Last updated
08/22/2020
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