Harris Home in Jacksonville - Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities
Harris Home - NPI 1790981728
Harris Home is a Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities in Jacksonville, North Carolina. Harris Home practices all healthcare services and medical treatments related to Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities. The NPI Number for Harris Home is 1790981728. The last update date is 2020-08-22.
Harris Home's current location address is 536 Shadowridge Rd, Jacksonville, North Carolina. You can contact this provider via phone number 9103539747. The mailing address for Harris Home is 536 Shadowridge Rd, Jacksonville, North Carolina. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Harris Home |
|---|---|
| Address | 536 Shadowridge Rd, Jacksonville, North Carolina |
| Phone Number | 9103539747 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | DIRECTOR-O |
|---|---|
| Authorized Official Name | Harris William |
| Telephone Number | 9103530124 |
NPI Number Detail
| NPI Number | 1790981728 |
|---|---|
| Provider Enumeration Date | 2007-06-26 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 536 Shadowridge Rd |
|---|---|
| City | Jacksonville |
| State | North Carolina (NC) |
| Post Code | 285467876 |
| Phone Number | 9103539747 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities |
|---|---|
| Taxonomy | 320900000X |
| Licence No | MHL-067-143 |
|
Definition: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 3409469 | NC | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Harris Home by the Centers for Medicare & Medicaid Services?
The Harris Home has been issued the NPI (National Provider Identifier) 1790981728 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please share the complete physical address where Harris Home is geographically located?
The Harris Home is physically situated at the following location: 536 Shadowridge Rd, Jacksonville, NC, 285467876.
What is Harris Home's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Harris Home's specialized field of practice is Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities, and the corresponding taxonomy code that categorizes this area of specialization is 320900000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1790981728 to Harris Home?
The Centers for Medicare & Medicaid Services originally issued the 1790981728 to Harris Home on 2007-06-26.
As of what date were the details related to Harris Home most recently updated or revised?
The information pertaining to Harris Home, including its address, specialty, and other relevant details, was last updated or revised on 2020-08-22.
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