Granville County Group Homes, Inc.

Primary specialty

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

License

MHL039002 Issued in NC

Legal business name

GRANVILLE COUNTY GROUP HOMES, INC.

Practice address

5509 Dorsey Rd
Oxford, NC 27565-8309

Phone

(919) 528-4610

NPI assigned

Jun 7, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Skip Skinner

Title

Director

Phone

(252) 438-6700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Granville ICF group Home Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 34G013

Legal name

GRANVILLE ICF/MR GROUP HOME

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Jun 22, 1981

Last certification

Jun 10, 2025

Beds

5

Ownership / control type

Private (proprietary)

Facility address

5509 Dorsey Road
Oxford, NC 27565

Locations

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457554594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5509 DORSEY RD",
            "city": "OXFORD",
            "state": "NC",
            "postal_code": "275658309",
            "telephone_number": "919-528-4610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5509 DORSEY RD",
            "city": "OXFORD",
            "state": "NC",
            "postal_code": "275658309",
            "telephone_number": "919-528-4610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANVILLE COUNTY GROUP HOMES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SKINNER",
        "authorized_official_first_name": "SKIP",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "252-438-6700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL039002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3406229",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Granville ICF group Home",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Glory to Glory Ministries House of Refuge
• Elizabeth Ann Goldbach, OTR
• Brian Golson, CCC-SLP
• Stephanie Danille Goshorn, M.D.
• Granville County DSS
• Granville County Schools
• Granville Family Medicine PA
• Granville Health Inc
• Granville Health Inc
• Granville Health Inc

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Oxford, NC
• Providers in Oxford, 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 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.