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Johnston County Group Homes, Inc.

Organization Active NPI Intellectual Disabilities Intermediate Care Facility · Pine Level, NC

NPI 1992902746 · NPPES record last updated Jul 30, 2008

Key facts

NPI
1992902746
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual Disabilities Intermediate Care Facility 315P00000X
License
MHL-051-113 (NC)
Legal business name
JOHNSTON COUNTY GROUP HOMES, INC.
Practice address
2172B Hwy 70a East
Pine Level, NC 27568
Phone
(919) 965-0340
Fax
(919) 965-0340
NPI assigned
Jun 27, 2007
Organization subpart
No

Authorized official

Name
Janet Gail Harper
Title
Administrator
Phone
(919) 965-0340

Corporate family (same tax ID) 3

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

National Provider Directory

Tax ID family
Johnston County Group Homes Inc (4 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X MHL-051-113 NC Yes

Addresses

Primary practice location

2172B Hwy 70a East
Pine Level, NC 27568

Mailing address

PO Box 1768
Smithfield, NC 27577-1768
Phone (919) 965-0340

Other identifiers

IdentifierTypeStateIssuer
3408949MedicaidNC

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 30, 2008.

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217376000000",
    "number": "1992902746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1768",
            "city": "SMITHFIELD",
            "state": "NC",
            "postal_code": "275771768",
            "telephone_number": "919-965-0340",
            "fax_number": "919-965-0340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2172B HWY 70A EAST",
            "city": "PINE LEVEL",
            "state": "NC",
            "postal_code": "27568",
            "telephone_number": "919-965-0340",
            "fax_number": "919-965-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSTON COUNTY GROUP HOMES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2008-07-30",
        "status": "A",
        "authorized_official_last_name": "HARPER",
        "authorized_official_first_name": "JANET",
        "authorized_official_middle_name": "GAIL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "919-965-0340"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "NC",
            "license": "MHL-051-113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408949",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Level, NC

All providers in Pine Level, NC · Intellectual Disabilities Intermediate Care Facility in North Carolina

Sources for this page

Verify at the official NPI Registry.