Individual provider · Type 1 NPI
Stehanie D. Wall
Mental Illness Community Based Residential Treatment Facility · Raeford, NC
NPI number
1083045306
Active
Practice location
1357 Wayside Rd
Raeford, NC 28376-6513
Mailing address
3204 High Plains Dr
Hope Mills, NC 28348-5726
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Illness Community Based Residential Treatment Facility Primary | 320800000X | MHL-047-152 (NC) |
| Case Manager/Care Coordinator | 171M00000X | 27-0962043 (SC) |
| Private Vehicle | 347C00000X | 27-0962043 (SC) |
Mental Illness Community Based Residential Treatment Facility: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
About NPI 1083045306
Stehanie D. Wall's National Provider Identifier is 1083045306, issued on Dec 12, 2013. The primary taxonomy on file is Mental Illness Community Based Residential Treatment Facility (320800000X), and the practice location is in Raeford, NC. The record was last updated on Jan 9, 2015.