Healthcare Provider Details

I. General information

NPI: 1538895768
Provider Name (Legal Business Name): HINTONS GROUP HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2022
Last Update Date: 12/23/2024
Certification Date: 12/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2728 S RIDGE AVE
CONCORD NC
28025-2854
US

IV. Provider business mailing address

4010 WILD OLIVE DR
HUNTERSVILLE NC
28078-3968
US

V. Phone/Fax

Practice location:
  • Phone: 252-205-7344
  • Fax:
Mailing address:
  • Phone: 125-220-5734
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: SPENCER HINTON
Title or Position: CEO
Credential:
Phone: 252-205-7344