1ST & 10 GROUP HOME INC NPI 1538234372

NPI Information

  • NPI: 1538234372
  • Provider Name: 1ST & 10 GROUP HOME INC
  • Classification: Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X
  • Entity Type: Organization
  • Address: 206 NORTH EAST STREET
    ROSEBORE, NC
    ZIP 28382
  • Phone: (910) 525-5488

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NPI Details

1ST & 10 GROUP HOME INC is a residential treatment facility emotionally disturbed children in Rosebore, NC. The provider is 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. 1ST & 10 GROUP HOME INC NPI is 1538234372. The provider is registered as an organization entity type.

The provider's business location address is:

206 NORTH EAST STREET
ROSEBORE, NC
ZIP 28382-353
Phone: (910) 525-5488
Fax: (910) 525-5433

The provider's authorized official is Jerris Cornelius Mcphail .
The authorized official title is President and has the following contact phone number (910) 299-0099.

The enumeration date for this NPI number is 11/21/2006 and was last updated on 3/28/2008.

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 Taxonomy Specialization License Number License State Primary
1322D00000XResidential Treatment Facility, Emotionally Disturbed ChildrenMHL082059NORTH 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
16603962MEDICAIDNORTH 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

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