Provider Demographics
NPI:1881825370
Name:CAROLINA HOMES FOR YOUTH INC
Entity Type:Organization
Organization Name:CAROLINA HOMES FOR YOUTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-255-8279
Mailing Address - Street 1:PO BOX 16488
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-8221
Mailing Address - Country:US
Mailing Address - Phone:336-255-6279
Mailing Address - Fax:336-274-6692
Practice Address - Street 1:11 GLENDALE OAKS COURT
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-8221
Practice Address - Country:US
Practice Address - Phone:336-855-3744
Practice Address - Fax:336-274-6692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-31
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9930909251B00000X
322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No251B00000XAgenciesCase Management