Homelife Group Home

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

MHL032544 Issued in NC

Legal business name

HOMELIFE GROUP HOME

Practice address

917 Lancaster St
Durham, NC 27701-1551

Phone

(919) 450-5640

NPI assigned

Aug 26, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Ben Johnson

Title

Director of Ops

Phone

(919) 450-5640

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1282780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282780800000",
    "number": "1093021115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 LANCASTER ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277011551",
            "telephone_number": "919-450-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 LANCASTER ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277011551",
            "telephone_number": "919-450-5640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMELIFE GROUP HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-26",
        "last_updated": "2010-08-26",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "BEN",
        "authorized_official_title_or_position": "DIRECTOR OF OPS",
        "authorized_official_telephone_number": "919-450-5640",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL032544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer E Holton, MD
• Danya Holtzman, MSW, LCSWA
• Christina Teresa Holub, APRN
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• Amber A Honeycutt, LMBT
• Lisa Kristen Honeycutt, MA

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Durham, NC
• Providers in Durham, NC by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.