Organization · Type 2 NPI

Faith Home, Inc.

Emotionally Disturbed Childrens' Residential Treatment Facility · Greensboro, NC

NPI number 1649449091 Active

Practice location

808 Mystic Dr
Greensboro, NC 27406-5726

Call (336) 856-0671 Map

Fax (336) 856-0671

Mailing address

2501 Donlora Dr
Greensboro, NC 27407-6015

Specialties and licenses

Taxonomy	Code	License
Emotionally Disturbed Childrens' Residential Treatment Facility Primary	322D00000X	MHL041732 (NC)

Emotionally Disturbed Childrens' Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.

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NPI record

NPI: 1649449091
Entity type: Organization (Type 2)
Issued: Feb 29, 2008
Last updated: Apr 7, 2008
Status: Active
Subpart: Yes of Faith Home, Inc.

Other names

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Faith Home · doing business as

Authorized official

Mr. Leon Harlie Sturdivant, DIRECT OWNER (DO)
Owner / Director
(336) 854-1718

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1649449091

Faith Home, Inc.'s National Provider Identifier is 1649449091, issued on Feb 29, 2008. The primary taxonomy on file is Emotionally Disturbed Childrens' Residential Treatment Facility (322D00000X), and the practice location is in Greensboro, NC. The record was last updated on Apr 7, 2008.