| Carolina Residential Services, Inc. | |
|
130 Williams St Boonville NC 27011-9300 | |
| (336) 367-9039 | |
| (336) 367-9039 |
| Full Name | Carolina Residential Services, Inc. |
|---|---|
| Speciality | Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities |
| Location | 130 Williams St, Boonville, North Carolina |
| Authorized Official Name and Position | Susan M Kincaid (DIRECTOR) |
| Authorized Official Contact | 8285722333 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolina Residential Services, Inc. Po Box 286 Rutherford College NC 28671-0286 Ph: (828) 572-2333 | Carolina Residential Services, Inc. 130 Williams St Boonville NC 27011-9300 Ph: (336) 367-9039 |
| NPI Number | 1427180975 |
|---|---|
| Provider Enumeration Date | 03/11/2007 |
| Last Update Date | 07/20/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427180975 | NPI | - | NPPES |
| 7806585 | Medicaid | NC | |
| 7805080 | Medicaid | NC |
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