Organization Name: | MY SISTER'S PLACE COMMUNITY SERVICES, INC. |
NPI Number: | 1013107143 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOAN MARIE WHITE (CEO & EXECUTIVE DIRECTOR) |
Mailing Address: | 2925 S Main St Winston Salem |
State: | NC US |
Postal Code: | 271274006 |
Phone Number: | 3367845922 |
Fax Number: | 3366509516 |
NPI Enumeration Date: | 07/25/2007 |
NPI Last Update Date: | 07/25/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320900000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |