Healthcare Provider Details

I. General information

NPI: 1053047365
Provider Name (Legal Business Name): BROWNSTONE FAMILY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2022
Last Update Date: 07/28/2022
Certification Date: 07/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 CEDAR LODGE RD
THOMASVILLE NC
27360-6204
US

IV. Provider business mailing address

44 CEDAR LODGE RD
THOMASVILLE NC
27360-6204
US

V. Phone/Fax

Practice location:
  • Phone: 919-972-9004
  • Fax:
Mailing address:
  • Phone: 919-972-9004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. SA'D THOMPSON
Title or Position: OWNER
Credential:
Phone: 919-972-9004