Provider Demographics
NPI:1306161013
Name:GUIDING STAR HEALTH CARE ADULT GROUP HOME
Entity type:Organization
Organization Name:GUIDING STAR HEALTH CARE ADULT GROUP HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-937-1700
Mailing Address - Street 1:2809 HUNTINGTON CT
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27803-1641
Mailing Address - Country:US
Mailing Address - Phone:252-937-1700
Mailing Address - Fax:252-557-4810
Practice Address - Street 1:2809 HUNTINGTON CT
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27803-1641
Practice Address - Country:US
Practice Address - Phone:252-937-1700
Practice Address - Fax:252-557-4810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-06
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL 064- 114177F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes177F00000XOther Service ProvidersLodgingGroup - Single Specialty