NPIMap

Organization Active NPI

Lee County Group Home, Inc.

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Sanford, NC
National Provider Identifier
1588760433
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
MHL053041 Issued in NC
Legal business name
LEE COUNTY GROUP HOME, INC.
Practice address
2412 Knollwood Dr
Lee # 2
Sanford, NC 27330-7671
Phone
(919) 776-9189
Fax
(919) 774-7711
NPI assigned
Sep 16, 2006
Last updated
Mar 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Authorized official

Name
Judieth Autry
Title
General Board Financial
Phone
(919) 770-5484

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X MHL053041 NC Primary

Addresses

Primary practice location

2412 Knollwood Dr
Lee # 2
Sanford, NC 27330-7671

Mailing address

PO Box 1373
Lee # 2
Sanford, NC 27331-1373
Phone (919) 776-9189

Other identifiers 1

IdentifierTypeStateIssuer
780514MedicaidNC

Other names 1

  • Lee #2 Other name

National Provider Directory

National Provider Directory
Tax ID family
Lee County Group Homes5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742515200000",
    "number": "1588760433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1373",
            "address_2": "LEE # 2",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273311373",
            "telephone_number": "919-776-9189",
            "fax_number": "919-774-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2412 KNOLLWOOD DR",
            "address_2": "LEE # 2",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273307671",
            "telephone_number": "919-776-9189",
            "fax_number": "919-774-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEE COUNTY GROUP HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2025-03-21",
        "status": "A",
        "authorized_official_last_name": "AUTRY",
        "authorized_official_first_name": "JUDIETH",
        "authorized_official_title_or_position": "GENERAL BOARD FINANCIAL",
        "authorized_official_telephone_number": "919-770-5484"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL053041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "780514",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lee #2",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sanford, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2025; 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.