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Marquita Latrice Walls
Emotionally Disturbed Childrens' Residential Treatment Facility in Grover, North Carolina
NPI 1821631532

Marquita Latrice Walls is a Emotionally Disturbed Childrens' Residential Treatment Facility based in Gastonia, NC. Marquita Latrice Walls practices in Grover, NC. The NPI Number for Marquita Latrice Walls is 1821631532 and holds a License No. (North Carolina).

The current practice location address for Marquita Latrice Walls is 1565 Longbranch Rd, Grover, NC and can be reached out via phone at 704-915-0282.

Location: 1565 Longbranch Rd, Grover, NC, 28054-1770
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1821631532
Provider Name
Marquita Latrice Walls
Credential
Provider Entity Type
Individual
Gender
Female
Address
1565 Longbranch Rd, Grover, NC, 28054-1770
Phone Number
704-915-0282
Fax Number
Provider Enumeration Date
10/25/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1565 Longbranch Rd
City
Grover
State
North Carolina
Zip
28073-9599
Phone Number
704-915-0282
Fax Number
person
Provider Business Mailing Address Details
Address
1565 Longbranch Rd
City
Grover
State
North Carolina
Zip
28073-9599
Phone Number
704-915-0282
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Emotionally Disturbed Children
Speciality
-
Taxonomy
322D00000X
License No.
()
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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