Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Church Street Group Home LLC

Organization Assisted Living Facility (Mental Illness) · NPI 1821389776

Church Street Group Home LLC is an Assisted Living Facility (Mental Illness) in Burlington, North Carolina. Licensed in North Carolina. Registered with an NPI since 2011.

Licensed in
NC
In the registry since
2011
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1017 S Church St
Burlington, NC 27215-5045
Phone: (336) 227-1613
Fax: (336) 227-1613
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Assisted Living Facility (Mental Illness) (primary) Taxonomy 3104A0625X · Licence MHL-001-213 (NC)

Record details

NPI number1821389776
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mittie Fuller — President/Owner · (336) 227-1613
NPI enumeratedApril 27, 2011
Last updated in NPPESApril 27, 2011
Mailing addressPo Box 1996, Burlington, NC 27216-1996

Other providers in Burlington