DHSR ICF/IID Facilities - NC DHHS

1 ALAMANCEP oplar Street Group HomeRalph Scott Lifeservices, : 328 Poplar Street, Graham, NC, 27253(336) 227-1011 MHL-001-007 ADM: Brittany MayakOWN: Jennifer Helton, Pres. & - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G022 Ralph Scott Lifeservices, Scott Lifeservices, : 710 Townbranch Road, Graham, NC, 27253(336) 227-1011 MHL-001-008 ADM: Brittany MayakOWN: Jennifer Helton, Pres. & - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G021 Ralph Scott Lifeservices, Drive Group HomeRalph Scott Lifeservices, : 108 Laramie Drive, Mebane, NC, 27302(336) 227-1011 MHL-001-027 ADM: Brittany MayakOWN: Jennifer Helton, Pres. & - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G223 Ralph Scott Lifeservices, DriveRalph Scott Lifeservices, : 500 Veterans Drive, Elon College, NC, 27244(336) 227-1011 MHL-001-030 ADM: Brittany MayakOWN: Jennifer Helton-Pres.

2 & - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G304 Ralph Scott Lifeservices, StreetRalph Scott Lifeservices, : 304 Rosemont Street, Gibsonville, NC, 27249(336) 227-1011 MHL-001-031 ADM: Brittany MayakOWN: Jennifer Helton, - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G311 ALEXANDERL ittle River Group HomeComServ, : 4161 NC Hwy 127, Taylorsville, NC, 28681(828) 728-9288 MHL-002-005 ADM: Paige AndersonOWN: Dawn Kelly, CEOMGMT: ComServ, - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G219 VOCA-Second Avenue Group HomeVOCA Corporation of North CarolinaSITE: 49 Second Avenue SE, Taylorsville, NC, 28681(828) 635-1757 MHL-002-007 ADM: Tracey NorrisOWN: Patrick Kelley, - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G280 Ellendale Group HomeComServ, : 4165 NC Highway 127, Taylorsville, NC, 28681(828) 728-9288 MHL-002-010 ADM: Paige AndersonOWN: Dawn Kelly, CEOMGMT: ComServ, - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G327 ALLEGHANYNew River Cottage, River Cottage, : 82 Davis Lane, Sparta, NC, 28675(336) 372-5671 MHL-003-003 ADM: Mitch FranklinOWN: Darlene Douglas,Exe Dir, - Beds : 5, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G026 ANSONA nsonville Group HomeMonarchSITE: 1215 Ansonville/Polkton Rd.

3 , Ansonville, NC, 28007(704) 826-6233 MHL-004-004 ADM: Contracts ManagerOWN: Peggy Terhune, - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G206 ASHEPage: 1As of 09/2022 DHSR ICF/IID FacilitiesRidgecrest IIRHA Health Services NC, LLCSITE: 421 Ridgecrest Avenue, West Jefferson, NC, 28694(336) 246-7020 MHL-005-009 ADM: Luray RomingerOWN: Gordon Simmons,CEOMGMT: RHA Health Management Services, - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G155 Ridgecrest IRHA Health Services NC, LLCSITE: 310 Locust Street, West Jefferson, NC, 28694(336) 246-7010 MHL-005-010 ADM: Luray RomingerOWN: Gordon Simmons, CEOMGMT: RHA Health Management Services, - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G155 Thomas Street HomeRHA Health Services NC, LLCSITE: 348 Thomas St., Jefferson, NC, 28640(336) 246-7030 MHL-005-011 ADM: Luray RomingerOWN: Gordon Simmons,CEOMGMT: RHA Health Management Services, - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G163 BEAUFORTLife, Group HomeLIFE, : 77 Edgewood Drive, Chocowinity, NC, 27817(252) 975-6468 MHL-007-006 ADM: Richard SmithOWN: Sharon L.

4 Raynor, - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G182 LIFE, Road Group HomeLIFE, : 1383 Dixon Road, Chocowinity, NC, 27817(252) 975-1220 MHL-007-008 ADM: Richard L SmithOWN: Sharon L. - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G205 Life, Road Group HomeLife, : 332 Slatestone Road, Washington, NC, 27889(252) 946-9055 MHL-007-013 ADM: Richard L SmithOWN: - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G325 LIFE, Heights Group HomeLIFE, : 103 Circle Street, Washington, NC, 27889(252) 946-4133 MHL-007-014 ADM: Ricky SmithOWN: - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G339 LIFE, Man Group HomeLIFE, : 388 Minute Man Lane, Washington, NC, 27889(252) 946-5563 MHL-007-015 ADM: Richard L SmithOWN: - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G338 BLADENN orthridge ResidentialCommunity Innovations, : 68 Mitchell Ford Road, Clarkton, NC, 28433(910) 647-2801 MHL-009-009 ADM: Cheryl KellyOWN: Gene Rodgers - Exc.

5 - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G232 Midlake ResidentialCommunity Innovations, : 68 Hillside Street, Clarkton, NC, 28433(910) 647-4421 MHL-009-010 ADM: Cheryl KellyOWN: Gene L. Rodgers - Executive - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G257 BRUNSWICKPage: 2As of 09/2022 DHSR ICF/IID FacilitiesLife, Street Group HomeLife, : 65 Folly Street SW, Supply, NC, 28462(910) 754-2855 MHL-010-008 ADM: Ricky SmithOWN: Sharon L. Raynor- - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G235 Life, Street Group HomeLife, : 156 Country Side St. Drive, Supply, NC, 28462(910) 754-2854 MHL-010-009 ADM: Ricky SmithOWN: Sharon L. Raynor, - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G234 BUNCOMBEBlueWest Opportunities-Swannanoa ResidentialBlueWest Opportunities, : 91 Poplar Circle, Swannanoa, NC, 28778(828) 251-2824 MHL-011-007 ADM: Tina WoodyOWN: Chrissie Gulden, - Beds : 32, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G089 BlueWest Opportunities-Ora HouseBlueWest Opportunities, : 95 Ora Street, Asheville, NC, 28801(828) 251-2824 MHL-011-011 ADM: Tina WoodyOWN: Chrissie Gulden, - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G031 IWC-Rose Street HomeIrene Wortham Residential Center, : 1 Rose Street W, Asheville, NC, 28803(828) 274-7518 MHL-011-022 ADM: Matthew HenryOWN: Exec.

6 - Beds : 12, Description : Specialized Community Residential Centers for Individuals with Developmental DisabilitiesCCN: 34G076 Chiles Avenue Group HomeMountain Area Residential Facilities , : 22 Chiles Avenue, Asheville, NC, 28803(828) 845-8434 MHL-011-024 ADM: Caroline BassOWN: Jeanne Cagle - Executive - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G075 Irene Wortham Residential Center-AzaleaIrene Wortham Residential Center, : 16 Azalea Street, Asheville, NC, 28803(828) 274-7518 MHL-011-036 ADM: Matthew HenryOWN: Exec. - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G150 BlueWest Opportunities-Pisgah HouseBlueWest Opportunities, : 28 Pisgahview Avenue, Asheville, NC, 28803(828) 274-8368 MHL-011-047 ADM: Tina WoodyOWN: Chrissie Gulden, - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G209 BlueWest Opportunities-Kenmore HouseBlueWest Opportunities, : 1 Kenmore Street, Asheville, NC, 28803(828) 274-8368 MHL-011-076 ADM: Tina WoodyOWN: Chrissie Gulden, - Beds : 6, Description : Supervised Living for Minors with Developmental DisabilitiesCCN: 34G267 BlueWest Opportunities-Montford HouseBlueWest Opportunities, : 5 Kenmore Street, Asheville, NC, 28803(828) 251-2824 MHL-011-105 ADM: Tina WoodyOWN: Chrissie Gulden, - Beds : 5, Description : Supervised Living for Minors with Developmental DisabilitiesCCN: 34G323 IWRC-DogwoodIrene Wortham Residential Center.

7 2 Rose Street W, Asheville, NC, 28803(828) 274-7518 MHL-011-108 ADM: Matthew HenryOWN: Exec. - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G334 BlueWest Opportunities-New Stock HouseBlueWest Opportunities, : 122 Woodland Hills Road, Asheville, NC, 28804(828) 251-2824 MHL-011-137 ADM: Tina WoodyOWN: Chrissie Gulden, - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G344 Page: 3As of 09/2022 DHSR ICF/IID FacilitiesEmory Road HomeRHA Health Services NC, LLCSITE: 20 Emory Road, Asheville, NC, 28806(828) 684-1940 MHL-011-351 ADM: Katherine BentonOWN: Gordon Simmons, CEOMGMT: RHA Health Management Services, - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: BURKEH artland Group HomeComServ, : 2307 Hartland Road, Morganton, NC, 28655(828) 728-9288 MHL-012-043 ADM: Paige AndersonOWN: Dawn Kelley, CEOMGMT: ComServ, - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN.

8 34G264 Chesterfield Group HomeComServ, : 2287 Hartland Road, Morganton, NC, 28655(828) 728-9928 MHL-012-051 ADM: Paige AndersonOWN: Dawn Kelley, CEOMGMT: ComServ, - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G301 SCI-Burke ICF/MR Group HomeSkill Creations, : 101 Stephens Drive, Morganton, NC, 28655(828) 438-6243 MHL-012-105 ADM: Danielle AllenOWN: Paul Hackman - Beds : 5, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: CABARRUSM ichigan Street HomePiedmont Residential Developmental Center, : 1006 Michigan Street, Kannapolis, NC, 28083(704) 788-2304 MHL-013-005 ADM: Lisa CoxOWN: Lisa Azzarello, Director Of - Beds : 5, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G019 Bost Children's CenterPiedmont Residential Development Center, : 5300 Highway 200, Concord, NC, 28025(704) 786-1405 MHL-013-006 ADM: Lisa CoxOWN: Lisa Azzarello, Director of - Beds : 10, Description : Specialized Community Residential Centers for Individuals with Developmental DisabilitiesCCN: 34G011 Clear CreekRHA Health Services NC, LLCSITE: 11950 Howell Center Drive, Charlotte, NC, 28227(704) 545-7200 MHL-013-007 ADM: Samuel WilliamsOWN: Gordon SimmonsMGMT: RHA Health Management Services, - Beds : 120, Description : Specialized Community Residential Centers for Individuals with Developmental - Beds : 0, Description : Adult Developmental Vocational Programs for Individuals with Developmental DisabilitiesCCN: 34G038 Clear CreekRHA Health Services NC, LLCSITE: 11950 Howell Center Drive, Charlotte, NC, 28227(704) 545-7200 MHL-013-007 ADM: Samuel WilliamsOWN: Gordon SimmonsMGMT: RHA Health Management Services, - Beds : 120, Description : Specialized Community Residential Centers for Individuals with Developmental - Beds : 0, Description.

9 Adult Developmental Vocational Programs for Individuals with Developmental DisabilitiesCCN: 34G038 Christy Woods Group HomePiedmont Residential Development Center, : 10100 Mt. Olive Road, Mt. Pleasant, NC, 28124(704) 436-6013 MHL-013-018 ADM: Lisa CoxOWN: Lisa Azzarello, Director Of - Beds : 5, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G132 Wilhelm Place HomePiedmont Residential Development Center, : 630 Wilhelm Place, Concord, NC, 28026(704) 782-1706 MHL-013-019 ADM: Lisa CoxOWN: Lisa Azzarello, Director Of - Beds : 5, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G153 CALDWELLPage: 4As of 09/2022 DHSR ICF/IID FacilitiesCreekside Group HomeComServ, : 723 Hills Farm Street, Lenoir, NC, 28645(828) 728-9288 MHL-014-025 ADM: Paige AndersonOWN: Dawn Kelley, CEOMGMT: ComServ, - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G230 VOCA-Laurel Group HomeVOCA Corporation of North CarolinaSITE: 51 Laurel Street, Granite Falls, NC, 28630(828) 396-5879 MHL-014-031 ADM: Tracey NorrisOWN: Patrick Kelley, - Beds.

10 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G287 Playmore Group HomeCom-Serv, : 3252 Playmore Beach Road, Morganton, NC, 28655(828) 728-9288 MHL-014-038 ADM: Paige AndersonOWN: Dawn Kelley, CEOMGMT: ComServ, - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G340 Lower Creek Group HomeComServ, : 3256 Playmore Beach Road, Morganton, NC, 28655(828) 728-9288 MHL-014-039 ADM: Paige AndersonOWN: Dawn Kelly, CEOMGMT: ComServ, - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G343 CARTERETLIFE, Fox Run Group HomeLIFE, : 312 Grey Fox Run, Newport, NC, 28570(252) 223-2466 MHL-016-011 ADM: Ricky SmithOWN: - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G286 LIFE, Foot Road Group HomeLIFE, : 1229 Nine Foot Road, Newport, NC, 28570(252) 223-3774 MHL-016-012 ADM: Ricky SmithOWN: - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G285 CATAWBAP enny Lane #1 RHA Health Services NC, LLCSITE: 2840 Hwy 70 East, Claremont, NC, 28610(828) 459-0588 MHL-018-011 ADM: Leslie BurlesonOWN: Gordon Simmons, CEOMGMT: RHA Health Management Services, - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: 34G08723rd Street HomeRHA Health Services NC, LLCSITE: 804 East 23rd Street, Newton, NC, 28658(828) 465-2114 MHL-018-014 ADM: Leslie BurlesonOWN: Gordon Simmons, CEOMGMT: RHA Health Management Services, - Beds : 6, Description : Supervised Living for Adults with Developmental DisabilitiesCCN: Penny Lane IIRHA Health Services NC, LLCSITE: 2830 Highway 70 East, Claremont, NC, 28610(828) 459-1339 MHL-018-016 ADM: Michelle RobertsonOWN: Gordan Simmons, CEOMGMT: RHA Health Management Services, - Beds : 6, Description.