Bo's Johnathan House, Inc.

Primary specialty

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

License

MHL-051-168 Issued in NC

Legal business name

BO'S JOHNATHAN HOUSE, INC.

Doing business as

Bo's Johnathan House Adult Care, Inc.

Practice address

300 Will Rd
Middlesex, NC 27557-8317

Phone

(919) 369-5394

NPI assigned

Nov 25, 2008

Last updated

Jan 27, 2009By the provider in NPPES

Organization subpart

Yes

Parent organization

BO'S JOHNATHAN HOUSE, INC.As reported in NPPES

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

Authorized official

Name

Mrs. Obelia Watson Hocutt

Title

Executive Director

Phone

(919) 369-5394

Specialties & licenses 2

Addresses

Other names 1

• Bo's Johnathan House Adult Care, Inc. Doing business as

Part of

Bo's Johnathan House Inc

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

{
    "created_epoch": "1227571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233014400000",
    "number": "1194970681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12749 BUCK RD",
            "city": "MIDDLESEX",
            "state": "NC",
            "postal_code": "275578308",
            "telephone_number": "919-269-7502",
            "fax_number": "919-269-7502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 WILL RD",
            "city": "MIDDLESEX",
            "state": "NC",
            "postal_code": "275578317",
            "telephone_number": "919-369-5394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BO'S JOHNATHAN HOUSE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BO'S JOHNATHAN HOUSE, INC.",
        "enumeration_date": "2008-11-25",
        "last_updated": "2009-01-27",
        "status": "A",
        "authorized_official_last_name": "HOCUTT",
        "authorized_official_first_name": "OBELIA",
        "authorized_official_middle_name": "WATSON",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "919-369-5394",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-051-168",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-051-168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bo's Johnathan House Adult Care, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Middlesex, NC
• Providers in Middlesex, 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 Jan 27, 2009; 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.