MEDICARE: A PLACE OF THEIR OWN,LLC

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	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility	MHL-041-852	NC
2	320800000X	Mental Illness Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1821291493
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A PLACE OF THEIR OWN,LLC

Provider Business Mailing Address
First Line	:	5629 BURLINGTON RD
Second Line	:	1525 BOWMORE PLACE
City	:	MC LEANSVILLE
State	:	NC
Zip	:	27301-9209
Country	:	US
Telephone Number	:	336-382-0178
Fax Number	:	336-697-7484

Provider Business Practice Location Address
First Line	:	5629 BURLINGTON RD
Second Line	:	1525 BOWMORE PLACE
City	:	MC LEANSVILLE
State	:	NC
Zip	:	27301-9209
Country	:	US
Telephone Number	:	336-382-0178
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MISS CHANISTY H MITCHELL
Credential	:
Telephone Number	:	336-382-0178

Provider Enumeration Date	:	06/08/2007
Last Update Date	:	08/17/2020

Similar Medicare Providers

1164384087 — UNLIMITED SUPPORTS & CONSULTING AGENCY LLC
Practice Location Address:

5103 MALLISON WAY
MC LEANSVILLE, NC
27301-9004

Practice Phone: 336-303-6922
Practice Fax: 336-303-6922

1295702900 — DIANA SUE BURNS LCSW, LCAS
Practice Location Address:

4902 NORTHBEND RD
MC LEANSVILLE, NC
27301-9794

Practice Phone: 336-404-2662
Practice Fax:

1497844302 — SYLVANGLADE HOME, INC.
Practice Location Address:

4915 SYLVANGLADE RD
MC LEANSVILLE, NC
27301-9753

Practice Phone: 336-772-0952
Practice Fax: 336-356-2156

1710005350 — MRS. URSULA MICHELE FRISON M.S., LPC
Practice Location Address:

6720 MCLEANSVILLE RD
MC LEANSVILLE, NC
27301-9716

Practice Phone: 336-375-2525
Practice Fax:

1386850188 — R. HARRIS DANIEL, D.D.S.
Practice Location Address:

5706 MCLEANSVILLE RD
MC LEANSVILLE, NC
27301-9303

Practice Phone: 336-697-0618
Practice Fax: 336-697-9478

1629273610 — SYLVANGLADE HOME, INC.
Practice Location Address:

4915 SYLVANGLADE RD
MC LEANSVILLE, NC
27301-9753

Practice Phone: 336-358-2156
Practice Fax:

Directions to “A PLACE OF THEIR OWN,LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.