Organization
ALPHA DELTA FAMILY SERVICES GROUP, INC.
Active
Other names
Jacobs Tree House
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRINA D TORAIN (QUALIFIED PROFESSIONAL)
(336) 562-5300
Entity
Organization
Contact information
Practice address
7612 N NC HIGHWAY 49, MEBANE, NC 27302-7519
(336) 562-5300
(336) 562-5500
Mailing address
7612 N NC HIGHWAY 49, MEBANE, NC 27302-7519
(336) 562-5300
(336) 562-5500
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-068-111
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603634
—
NC
Enumeration date
01/30/2007
Last updated
08/22/2020
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