| Carolina Residential Services, Inc | |
| 
					730 N Mulberry St Statesville NC 28677-3233  | |
| (704) 883-0647 | |
| (704) 873-4458 | 
| Full Name | Carolina Residential Services, Inc | 
|---|---|
| Speciality | Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities | 
| Location | 730 N Mulberry St, Statesville, North Carolina | 
| Authorized Official Name and Position | Susan M Kincaid (DIRECTOR) | 
| Authorized Official Contact | 8285722333 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Carolina Residential Services, Inc Po Box 286 Rutherford College NC 28671-0286 Ph: (828) 572-2333  | Carolina Residential Services, Inc 730 N Mulberry St Statesville NC 28677-3233 Ph: (704) 883-0647  | 
| NPI Number | 1811030463 | 
|---|---|
| Provider Enumeration Date | 02/14/2007 | 
| Last Update Date | 07/20/2013 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1811030463 | NPI | - | NPPES | 
| 7803402 | Medicaid | NC | |
| 7806600 | Medicaid | NC | 
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