Provider Demographics
NPI:1508106394
Name:CARTER'S CIRCLE OF CARE, INC
Entity Type:Organization
Organization Name:CARTER'S CIRCLE OF CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP/DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:336-375-2150
Mailing Address - Street 1:4137 KEELY RD
Mailing Address - Street 2:
Mailing Address - City:MC LEANSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27301-9746
Mailing Address - Country:US
Mailing Address - Phone:336-375-2150
Mailing Address - Fax:
Practice Address - Street 1:2031 MARTIN LUTHER KING JR DR
Practice Address - Street 2:SUITE E
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-3342
Practice Address - Country:US
Practice Address - Phone:336-271-5888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-15
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL0411052322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children