Organization · Type 2 NPI
Our Fathers Place Inc
Emotionally Disturbed Childrens' Residential Treatment Facility · Stateville, NC
Practice location
115 North Oakwood Drive
Stateville, NC 28677-5325
Fax (704) 872-7787
Mailing address
256 East Broad Street
Statesville, NC 28677-5325
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Emotionally Disturbed Childrens' Residential Treatment Facility Primary | 322D00000X | MHL049095 (NC) |
Emotionally Disturbed Childrens' Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
About NPI 1831252675
Our Fathers Place Inc's National Provider Identifier is 1831252675, issued on Dec 19, 2006. The primary taxonomy on file is Emotionally Disturbed Childrens' Residential Treatment Facility (322D00000X), and the practice location is in Stateville, NC. The record was last updated on Aug 22, 2020.