| NPI | 1851447221 |
|---|---|
| Doing Business As | MOUNTAIN RIDGE GROUP HOME |
| Entity Type | Organization |
| Authorized Contact | KIRBY NICKERSON Chief Financial Officer 704-754-8228 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: NC MHL036031) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-036-031) | |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2017-06-26 |