Organization
CAROLINA THERAPEUTIC CHILDREN AND FAMILY SERVICES, INC
Active
Other names
Wicker Street Group nHome
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EVERETT JONES (CEO)
(336) 684-5005
Entity
Organization
Contact information
Practice address
809 WICKER ST, 809 WICKER STREET, BURLINGTON, NC 27217-2362
(336) 684-5005
(336) 226-3727
Mailing address
809 WICKER ST, 809 WICKER STREET, BURLINGTON, NC 27217-2362
(336) 684-5005
(336) 226-3727
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
MHL-001-202
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FACILITY ID 930773
DEPARTMENT OF HEALTH AND HUMAN SERVICES
NC
Enumeration date
10/15/2010
Last updated
10/15/2010
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