Healthcare Provider Details

I. General information

NPI: 1114073814
Provider Name (Legal Business Name): CHISHOLM HOMES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 N SCIENTIFIC ST
HIGH POINT NC
27260-4337
US

IV. Provider business mailing address

431 N SCIENTIFIC ST
HIGH POINT NC
27260-4337
US

V. Phone/Fax

Practice location:
  • Phone: 336-887-2402
  • Fax: 336-887-2403
Mailing address:
  • Phone: 336-887-2402
  • Fax: 336-887-2403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. PENNY S CHISHOLM
Title or Position: DIRECTOR
Credential:
Phone: 336-887-2402