Provider Demographics
NPI:1306461926
Name:OUR HOME AT HOME
Entity type:Organization
Organization Name:OUR HOME AT HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZER
Authorized Official - Prefix:
Authorized Official - First Name:CEARIRA
Authorized Official - Middle Name:S
Authorized Official - Last Name:COWAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-925-3476
Mailing Address - Street 1:PO BOX 37
Mailing Address - Street 2:
Mailing Address - City:CHERRYVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28021-0037
Mailing Address - Country:US
Mailing Address - Phone:980-925-3476
Mailing Address - Fax:
Practice Address - Street 1:316 BLACK ROCK SCHOOL RD
Practice Address - Street 2:
Practice Address - City:CHERRYVILLE
Practice Address - State:NC
Practice Address - Zip Code:28021-9544
Practice Address - Country:US
Practice Address - Phone:980-924-3476
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-09
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No251S00000XAgenciesCommunity/Behavioral Health