SCI - ROANOKE HOUSE NPI 1124031349

NPI Information

  • NPI: 1124031349
  • Provider Name: SCI - ROANOKE HOUSE
  • Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
  • Entity Type: Organization
  • Address: 105 CLEARFIELD DR
    ROANOKE RAPIDS, NC
    ZIP 27870
  • Phone: (252) 308-0902

Map and Directions

Get Directions

NPI Details

SCI - ROANOKE HOUSE is an intermediate care facility mentally retarded in Roanoke Rapids, NC. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. SCI - ROANOKE HOUSE NPI is 1124031349. The provider is registered as an organization entity type.

The provider's business location address is:

105 CLEARFIELD DR
ROANOKE RAPIDS, NC
ZIP 27870-327
Phone: (252) 308-0902

The provider's authorized official is Paul Hackmann .
The authorized official title is Ceo and has the following contact phone number (919) 734-7398.

The enumeration date for this NPI number is 8/15/2006 and was last updated on 1/18/2019.

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
1313M00000XNursing Facility/Intermediate Care FacilityNo
2315P00000XIntermediate Care Facility, Intellectual DisabilitiesMHL-042-015NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
13406234MEDICAIDNORTH CAROLINA
23406347MEDICAIDNORTH CAROLINA
33406416MEDICAIDNORTH CAROLINA
43416197MEDICAIDNORTH CAROLINA
5340605GMEDICAIDNORTH CAROLINA
6340603TMEDICAIDNORTH CAROLINA
73406250MEDICAIDNORTH CAROLINA
83406401MEDICAIDNORTH CAROLINA
93406339MEDICAIDNORTH CAROLINA
103406386MEDICAIDNORTH CAROLINA
113406425MEDICAIDNORTH CAROLINA
123406243MEDICAIDNORTH CAROLINA
133406370MEDICAIDNORTH CAROLINA
143406065MEDICAIDNORTH CAROLINA
153406133MEDICAIDNORTH CAROLINA
163406361MEDICAIDNORTH CAROLINA

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: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI