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General NPI Number Information
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NPI Number | 1841741535
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Entity Type | Organization
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Legal Business Name | ES HOUSE INC
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Dates
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Enumeration Date | 10/18/2016
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Last Update Date | 10/18/2016
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Provider Practice Location Address
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Address Line | 612 E PRESNELL ST
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City | ASHEBORO
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State | NC
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Zip | 27203-4817
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Country | US
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Telephone | 336-328-4890
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1693
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City | SANFORD
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State | NC
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Zip | 27331-1693
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Country | US
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Telephone | 336-328-4890
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALFREDA ROBINSON
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Credential |
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Telephone | 336-328-4890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310500000X
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Taxonomy Name | Mental Illness Intermediate Care Facility
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License Number | MHL-076-114
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License Number State | NC
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