| Full Name | |
|---|---|
| Speciality | Residential Treatment Facility, Emotionally Disturbed Children |
| Location | 111 Sneed Dr, Clyde, North Carolina |
| Authorized Official Name and Position | Samuel V. Barefoot (TREASURER CFO) |
| Authorized Official Contact | 3364741224 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
204 Idol St P. O. Box 338 Thomasville NC 27360-4514 Ph: (336) 474-1276 | 111 Sneed Dr Clyde NC 28721-8468 Ph: (828) 627-9254 |
| NPI Number | 1033259403 |
|---|---|
| Provider Enumeration Date | 02/07/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033259403 | NPI | - | NPPES |
| 6005611 | Medicaid | NC |
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