1396936464 NPI number — CABARRUS COUNTY GROUP HOMES, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396936464 NPI number — CABARRUS COUNTY GROUP HOMES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CABARRUS COUNTY GROUP HOMES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396936464
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/11/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1197
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CONCORD
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28026-1197
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-855-0004
Provider Business Mailing Address Fax Number:
704-855-0045

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1212 STANLEY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALISBURY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28144-6220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-216-2274
Provider Business Practice Location Address Fax Number:
704-855-0045
Provider Enumeration Date:
08/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
POPE
Authorized Official First Name:
GINGER
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
704-855-0004

Provider Taxonomy Codes

  • Taxonomy code: 320600000X , with the licence number:  MHL-080-165 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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