NPIMap

Organization Active NPI

Welcome Home Group Home

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Rocky Mt, NC
National Provider Identifier
1104010677
Registry record updated Jul 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
MHL064085 Issued in NC
Legal business name
WELCOME HOME GROUP HOME
Practice address
1400 West Mount Dr
Rocky Mt, NC 27803-3107
Phone
(252) 443-0593
NPI assigned
Aug 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2008

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

Authorized official

Name
Stacy Vee FarrowNPI 1093837726
Title
Administrator
Phone
(252) 443-0593

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X MHL064085 NC
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X MHL064085 NC Primary

Addresses

Primary practice location

1400 West Mount Dr
Rocky Mt, NC 27803-3107

Mailing address

1400 West Mount Dr
Rocky Mount, NC 27803-3107
Phone (252) 443-0593

Other identifiers 1

IdentifierTypeStateIssuer
7805881MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Stacy Davenport-Baird Dba Welcome Home Group Home2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215043200000",
    "number": "1104010677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 WEST MOUNT DR",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278033107",
            "telephone_number": "252-443-0593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 WEST MOUNT DR",
            "city": "ROCKY MT",
            "state": "NC",
            "postal_code": "278033107",
            "telephone_number": "252-443-0593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELCOME HOME GROUP HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-28",
        "last_updated": "2008-07-03",
        "status": "A",
        "authorized_official_last_name": "FARROW",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "VEE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "252-443-0593"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NC",
            "license": "MHL064085",
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL064085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805881",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Mt, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2008; 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.