Provider Demographics
NPI:1396459848
Name:CAROLINA REBUILDING MINISTRY
Entity type:Organization
Organization Name:CAROLINA REBUILDING MINISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:DUVALL
Authorized Official - Suffix:
Authorized Official - Credentials:REV
Authorized Official - Phone:252-741-9502
Mailing Address - Street 1:3034 US HIGHWAY 64 E
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:NC
Mailing Address - Zip Code:27962-9678
Mailing Address - Country:US
Mailing Address - Phone:252-741-9502
Mailing Address - Fax:
Practice Address - Street 1:3034 US HIGHWAY 64 E
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:NC
Practice Address - Zip Code:27962-9678
Practice Address - Country:US
Practice Address - Phone:252-741-9502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-10
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty