Provider Demographics
NPI:1346379963
Name:CAROLINA THERAPEUTIC FAMILY AND CHILDREN SERVICES
Entity Type:Organization
Organization Name:CAROLINA THERAPEUTIC FAMILY AND CHILDREN SERVICES
Other - Org Name:CAROLINA CHILDREN AND FAMILY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EVERETT
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-684-5005
Mailing Address - Street 1:108 BROOKS ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-3702
Mailing Address - Country:US
Mailing Address - Phone:336-684-5005
Mailing Address - Fax:336-222-1380
Practice Address - Street 1:108 BROOKS ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-3702
Practice Address - Country:US
Practice Address - Phone:336-684-5005
Practice Address - Fax:336-222-1380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
Not Answered385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418064Medicaid