Provider Demographics
NPI:1851042592
Name:CAPE FEAR GROUP HOMES, INC.
Entity type:Organization
Organization Name:CAPE FEAR GROUP HOMES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALARICE
Authorized Official - Middle Name:YOLANDER
Authorized Official - Last Name:SMALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-251-2555
Mailing Address - Street 1:1852 BANKING ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-7222
Mailing Address - Country:US
Mailing Address - Phone:336-617-3157
Mailing Address - Fax:910-251-2555
Practice Address - Street 1:913 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-5756
Practice Address - Country:US
Practice Address - Phone:336-617-3157
Practice Address - Fax:910-251-2555
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAPE FEAR GROUP HOMES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-14
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health