The Jabez House, LLC

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

MHL-041-715 Issued in NC

Legal business name

THE JABEZ HOUSE, LLC

Practice address

1314 E Cone Blvd
Greensboro, NC 27405-4532

Phone

(336) 273-1987

Fax

(336) 273-1988

NPI assigned

Feb 20, 2007

Organization subpart

No

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

Authorized official

Name

Angela Davina Seabrooks

Title

Director

Phone

(336) 273-1987

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376688028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 324",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274020324",
            "telephone_number": "336-273-1987",
            "fax_number": "336-273-1988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 E CONE BLVD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274054532",
            "telephone_number": "336-273-1987",
            "fax_number": "336-273-1988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE JABEZ HOUSE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SEABROOKS",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "DAVINA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "336-273-1987"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL-041-715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603734",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Emotionally Disturbed Childrens' Residential Treatment Facility in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.