MEDICARE: TOUCHSTONE RESIDENTIAL SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1598182354
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOUCHSTONE RESIDENTIAL SERVICES

Provider Business Mailing Address
First Line	:	1224 COPELAND OAKS DR
Second Line	:
City	:	MORRISVILLE
State	:	NC
Zip	:	27560-6614
Country	:	US
Telephone Number	:	919-465-3277
Fax Number	:	919-465-3222

Provider Business Practice Location Address
First Line	:	7942 GARRETT RD
Second Line	:
City	:	LIBERTY
State	:	NC
Zip	:	27298-8656
Country	:	US
Telephone Number	:	336-653-7146
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. JEFFREY S JENKINS
Credential	:
Telephone Number	:	919-465-3277

Provider Enumeration Date	:	03/18/2014
Last Update Date	:	03/18/2014

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