MARTIN COUNTY RESIDENTIAL SERVICES INC. NPI 1124168141

NPI Information

NPI: 1124168141
Provider Name: MARTIN COUNTY RESIDENTIAL SERVICES INC.
Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Doing Business As: MARTIN ENTERPRISES
CLIA Number: 34D2044288
Address: 6003 WEST MAIN STREET
WILLIAMSTON, NC
ZIP 27892
Phone: (252) 792-8251

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NPI Details

MARTIN COUNTY RESIDENTIAL SERVICES INC. is a community based residential treatment facility, intellectual and/or developmental disabilities in Williamston, NC. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. MARTIN COUNTY RESIDENTIAL SERVICES INC. NPI is 1124168141. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Martin Enterprises.

The provider's business location address is:

6003 WEST MAIN STREET
WILLIAMSTON, NC
ZIP 27892
Phone: (252) 792-8251
Fax: (252) 792-5283

The provider's authorized official is Becky Renn .
The authorized official title is Executive Director and has the following contact phone number (252) 792-8251.

The CLIA number assigned to this NPI record is 34D2044288 - other - community rehab center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/7/2007 and was last updated on 7/28/2008.

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	License Number	License State	Primary
1	171M00000X	Case Manager/Care Coordinator	MHL058002	NORTH CAROLINA	No
2	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	MHL058004	NORTH CAROLINA	No
3	373H00000X	Day Training/Habilitation Specialist	MHL058002	NORTH CAROLINA	No
4	376J00000X	Homemaker	MHLO58003	NORTH CAROLINA	No
5	376J00000X	Homemaker	MHL058004	NORTH CAROLINA	No
6	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	MHL058003	NORTH CAROLINA	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: 11/21/2025

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