GRANDFATHER HOME - RALEIGH NPI 1629251293

NPI Information

NPI: 1629251293
Provider Name: GRANDFATHER HOME - RALEIGH
Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
5000 HOLLY RIDGE FARM RD
RALEIGH, NC
ZIP 27616
Phone: (828) 898-5465
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GRANDFATHER HOME - RALEIGH is a community based residential treatment facility mental illness in Raleigh, NC. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. GRANDFATHER HOME - RALEIGH NPI is 1629251293. The provider is registered as an organization entity type.

The provider's business location address is:

5000 HOLLY RIDGE FARM RD
RALEIGH, NC
ZIP 27616-121
Phone: (828) 898-5465
Fax: (828) 898-6140

The provider's authorized official is Jim Swinkola .
The authorized official title is Ceo and has the following contact phone number (828) 898-5465.

The enumeration date for this NPI number is 12/6/2007 and was last updated on 8/8/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320800000X	Community Based Residential Treatment Facility, Mental Illness				Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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