Provider Demographics
NPI:1811034531
Name:POINT FOF LOVE AND GRACE INC,
Entity Type:Organization
Organization Name:POINT FOF LOVE AND GRACE INC,
Other - Org Name:STONEY POINT GROUP HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIORECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GARRY
Authorized Official - Middle Name:MITCHELL
Authorized Official - Last Name:STEVENSON
Authorized Official - Suffix:
Authorized Official - Credentials:JD, QP
Authorized Official - Phone:704-435-8666
Mailing Address - Street 1:1419 FAWN RIDGE RD NW
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-9066
Mailing Address - Country:US
Mailing Address - Phone:704-788-2366
Mailing Address - Fax:704-723-6497
Practice Address - Street 1:1734 STONY POINT RD
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-9600
Practice Address - Country:US
Practice Address - Phone:704-435-8666
Practice Address - Fax:704-435-8666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL023098322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children