House of Phyll Empowers LLC

Primary specialty

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

Legal business name

HOUSE OF PHYLL EMPOWERS LLC

Practice address

425 S Main St
Roxboro, NC 27573-5527

Phone

(336) 514-8252

NPI assigned

Nov 9, 2023

Organization subpart

No

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

Authorized official

Name

Tracey Lynn Graves-Woodard

Title

Ceo

Phone

(336) 514-8252

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1699488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699488000000",
    "number": "1295509230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2586 NC HIGHWAY 57 N",
            "city": "MILTON",
            "state": "NC",
            "postal_code": "273059312",
            "telephone_number": "336-514-8252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 S MAIN ST",
            "city": "ROXBORO",
            "state": "NC",
            "postal_code": "275735527",
            "telephone_number": "336-514-8252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOUSE OF PHYLL EMPOWERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-09",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A",
        "authorized_official_last_name": "GRAVES-WOODARD",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "336-514-8252"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "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": []
}

• Monica D Hocutt, CRNA
• Stacy Lynne Hogan, DPT
• Lillian Hollars, PTA
• Tammie Meranda Holloway-Raines, MASTERS MENTAL DISAB
• Tabatha L Horner, NP
• Mary Bennett Houston, D.D.S.
• Jamie Blythe Huff, RPH
• Richard Hultz, PT
• La Monica Hunter, CPNP
• Daphne Ashley Hutchins

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Roxboro, NC
• Providers in Roxboro, 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 Nov 9, 2023; 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.