Harris Home

Primary specialty

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

License

MHL-067-143 Issued in NC

Legal business name

HARRIS HOME

Practice address

536 Shadowridge Rd
Jacksonville, NC 28546-7876

Phone

(910) 353-9747

NPI assigned

Jun 26, 2007

Organization subpart

No

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

Authorized official

Name

Mr. William Harris

Title

Director-Owner

Phone

(910) 353-0124

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Harris Home2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Harris Homes Agency

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Jacksonville, NC
  • NPI 1710005517
  NPD tax ID

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790981728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 STERLING RD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285468330",
            "telephone_number": "910-353-0124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "536 SHADOWRIDGE RD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467876",
            "telephone_number": "910-353-9747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARRIS HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "DIRECTOR-OWNER",
        "authorized_official_telephone_number": "910-353-0124",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-067-143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3409469",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leslie Hardman
• Christina Hardy
• Mary Christine Harness, LCSW
• Melina Harper
• Amanda Harrington, FNP-C
• Harris Homes Agency
• Gunner Robert Harris
• Keith A Harris, DDS
• Ralph Scott Harris, CPO
• Uganda Utice Harris, MA, LCMHC-A

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Jacksonville, NC
• Providers in Jacksonville, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.