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General NPI Number Information
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NPI Number | 1285890145
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Entity Type | Organization
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Legal Business Name | CAROLINA FAMILY CARE HOME LLC
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Dates
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Enumeration Date | 07/31/2008
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 5816 WILLOW POINT DR
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City | MORGANTON
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State | NC
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Zip | 28655-8602
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Country | US
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Telephone | 828-390-4370
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Fax | 828-390-4370
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Provider Business Mailing Address
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Address Line | 302 CHARLES AVE
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City | MORGANTON
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State | NC
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Zip | 28655-9059
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Country | US
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Telephone | 828-390-4370
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Fax | 828-391-1207
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Authorized Official
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Title or Position | PRESIDENT/ ONWER
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Name | MR. BOBBY LYNN JOLLY
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Credential |
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Telephone | 828-390-4370
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | FCL-012-035
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License Number State | NC
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