Healthcare Provider Details

I. General information

NPI: 1386259265
Provider Name (Legal Business Name): NEVAEHS CARING HANDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2020
Last Update Date: 09/09/2020
Certification Date: 09/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2509 DALTON RD
ROCKY MOUNT NC
27803-4721
US

IV. Provider business mailing address

2509 DALTON RD
ROCKY MOUNT NC
27803-4721
US

V. Phone/Fax

Practice location:
  • Phone: 252-955-5728
  • Fax:
Mailing address:
  • Phone: 252-955-5728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: VALERIE SAMPSON
Title or Position: CEO
Credential:
Phone: 252-955-5728