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Our Fathers Place Inc
Emotionally Disturbed Childrens' Residential Treatment Facility in Statesville, North Carolina
NPI 1346303187

Our Fathers Place Inc is a Emotionally Disturbed Childrens' Residential Treatment Facility based in Statesville, NC. Our Fathers Place Inc practices in Statesville, NC. The NPI Number for Our Fathers Place Inc is 1346303187 and holds a License No. MHL049093 (North Carolina).

The current practice location address for Our Fathers Place Inc is 413 Stockton Street, Statesville, NC and can be reached out via phone at 704-872-0313 and via fax at 704-872-7787.

Location: 413 Stockton Street, Statesville, NC, 28677-5325
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1346303187
Provider Name
Our Fathers Place Inc
Credential
Provider Entity Type
Organization
Address
413 Stockton Street, Statesville, NC, 28677-5325
Phone Number
704-872-0313
Fax Number
704-872-7787
Provider Enumeration Date
12/19/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
6603681 05 NC
institution
Provider Business Practice Location Address Details
Address
413 Stockton Street
City
Statesville
State
North Carolina
Zip
28677-5325
Phone Number
704-872-0313
Fax Number
704-872-7787
person
Provider Business Mailing Address Details
Address
413 Stockton Street
City
Statesville
State
North Carolina
Zip
28677-5325
Phone Number
704-872-0313
Fax Number
704-872-7787
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Emotionally Disturbed Children
Speciality
-
Taxonomy
322D00000X
License No.
MHL049093 (North Carolina)
Definition
A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
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