Organization Name: | CAROLINA RESIDENTIAL SERVICES, INC |
NPI Number: | 1275676959 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SUSAN M KINCAID (DIRECTOR) |
Mailing Address: | 516 Church St E Ahoskie |
State: | NC US |
Postal Code: | 279103524 |
Phone Number: | 2523323515 |
Fax Number: | 2523323521 |
NPI Enumeration Date: | 02/14/2007 |
NPI Last Update Date: | 11/01/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320900000X |
License Number: | MHL-046-005 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
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. |