WAYNE COUNTY GROUP HOMES (NPI# 1174674220) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174674220 |
| Entity Type | Organization |
| Organization Name | WAYNE COUNTY GROUP HOMES |
| Practice Address |
1109 Royall Ave Goldsboro NC 27534-2505 |
| Mailing Address |
Po Box 979 Goldsboro NC 27533-0979 |
| Practice Telephone | 9197347398 |
| Practice Fax Number | 9197355064 |
| Mailing Telephone | 9197347398 |
| Mailing Fax Number | 9197355064 |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. PAUL A HACKMANN (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9197347398 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 7804427 | 05 | |
| NC | 7803564 | 05 | |
| NC | 7803565 | 05 |
| Street Address |
1109 ROYALL AVE |
| City | GOLDSBORO |
| State | NC |
| Zip Code | 27534-2505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457875767 | Trent Jonathan Forshey | Physical Therapist | 2126 Wayne Memorial Dr, Goldsboro, NC 27534 | 2017-07-28 |
| 1336685551 | Wayne Al Holdings, LLC | Assisted Living Facility | 901 West New Hope Rd, Goldsboro, NC 27534 | 2017-01-11 |
| 1952845471 | Latoya Faulk | Social Worker | 121 Carolina Forest Drive, Goldsboro, NC 27534 | 2016-12-19 |
| 1528415841 | Kelby Joseph Sage Durnin | Military Health Care Provider | 1020 Jabara Avenue, Seymour Johnson Afb, NC 27534 | 2016-05-17 |
| 1528490604 | Eric Christian Bourgeois | Physical Therapist | 1101a Gracie Pl, Goldsboro, NC 27534 | 2013-07-31 |
| 1831439165 | Erica Nicole Davis | Optometrist | 20/20 Vision Center 625 North Berkeley Blvd, Suite D, Goldsboro, NC 27534 | 2013-02-23 |
| 1891039236 | Betty Webb Zimmerman | Nurse Practitioner | 204 Cox Blvd, Goldsboro, NC 27534 | 2012-11-26 |
| 1144595265 | Life Recovery Psychological Services | Counselor | 1202-c Wayne Memorial Dr, Goldsboro, NC 27534 | 2012-03-22 |
| 1558596536 | Taylor Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 802 Taylor St, Goldsboro, NC 27534 | 2009-05-20 |
| 1780895136 | Sherrie Fennell Edwards | Dietitian, Registered | 1500 Lanely Ave., Seymour Johnson Afb, Golsboro, NC 27534 | 2007-05-25 |
| Find all providers in zip 27534 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558596536 | Taylor Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 802 Taylor St, Goldsboro, NC 27534 | 2009-05-20 |
| 1366677361 | Lakeview | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 103 Lakeview Dr, Goldsboro, NC 27530-1125 | 2009-05-19 |
| 1871788638 | Freeman House Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1806 E Ash St, Goldsboro, NC 27530-4045 | 2007-09-13 |
| 1407055858 | Renu Life LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 304 S Pineview Ave, Goldsboro, NC 27530-6037 | 2007-07-16 |
| 1316169683 | Howell & Howell's LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 725 Luther Drive, Goldsboro, NC 27534 | 2007-05-03 |
| 1255485959 | Renu Life LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 102 Tinderwood Dr, Goldsboro, NC 27534-7856 | 2007-01-22 |
| 1346394012 | Renu Life Extended | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 501 Forest Hill Dr, Goldsboro, NC 27534-1824 | 2007-01-22 |
| 1275684664 | Hawthorne Services Incorporated | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1510 S Slocumb St, Goldsboro, NC 27530-6955 | 2007-01-14 |
| 1780743815 | Rha Health Services Nc, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 5709 Us Highway 70 E, Goldsboro, NC 27534-8155 | 2006-12-06 |
| 1063438695 | Nova I.c. Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 102 W Patetown Rd, 2307 Norwood Avenue, Goldsboro, NC 27530-1415 | 2006-07-15 |
| Find all providers in GOLDSBORO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.