34D2036319 CLIA NUMBER - ROUSES GROUP HOME INC

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Laboratory Demographics

CLIA Number: 34D2036319

Facility Name: ROUSES GROUP HOME INC

Facility Address:
5949 NC 135
STONEVILLE, NC
ZIP 27048
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Facility Phone Number: 336 427-0609

Facility Type: Other - SUPERVISED LIVING DD ADLT

Certificate Type: Waiver

NPI Number: 1841336062

Taxonomy: 315P00000X - Intermediate Care Facility, Intellectual Disabilities
An intermediate care facility providing services for individuals with intellectual disabilities.

CLIA Record

Field Name	Field Value
CLIA Number	34D2036319
LAB Type	Other - SUPERVISED LIVING DD ADLT
Facility Name	ROUSES GROUP HOME INC
Street	5949 NC 135
City	STONEVILLE
State	NC
ZIP	27048
Phone	336 427-0609
CertificateType	4
CertificateEffectiveDate	2/6/2024
CertificateExpirationDate	2/5/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024