Our Home Is Your Home

Primary specialty

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

Legal business name

OUR HOME IS YOUR HOME

Practice address

206 W Broad St
Elizabeth City, NC 27909-3521

Phone

(252) 338-3284

NPI assigned

Aug 12, 2009

Last updated

Aug 12, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Viola Beatrice Jackson, LPN

Title

Ceo/President

Phone

(252) 338-3284

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1250035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250035200000",
    "number": "1245462092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 W BROAD ST",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279093521",
            "telephone_number": "252-338-3284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 W BROAD ST",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279093521",
            "telephone_number": "252-338-3284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR HOME IS YOUR HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-12",
        "last_updated": "2009-08-12",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "VIOLA",
        "authorized_official_middle_name": "BEATRICE",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "252-338-3284",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Elizabeth City, NC
• Providers in Elizabeth City, 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 12, 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.