JABEZ RESIDENTIAL INC NPI 1629208699

NPI Information

  • NPI: 1629208699
  • Provider Name: JABEZ RESIDENTIAL INC
  • Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
  • Entity Type: Organization
  • Address: 212 TILGHMAN STREET
    KENLY, NC
    ZIP 27542
  • Phone: (919) 284-3723

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NPI Details

JABEZ RESIDENTIAL INC is a community based residential treatment facility, intellectual and/or developmental disabilities in Kenly, 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. JABEZ RESIDENTIAL INC NPI is 1629208699. The provider is registered as an organization entity type.

The provider's business location address is:

212 TILGHMAN STREET
KENLY, NC
ZIP 27542-214
Phone: (919) 284-3723

The provider's authorized official is Damien K Forsythe .
The authorized official title is Owner and has the following contact phone number (919) 284-3723.

The enumeration date for this NPI number is 7/23/2009 and was last updated on 7/23/2009.

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
1320900000XCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesMHL051174NORTH CAROLINAYes

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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