Healthcare Provider Details

I. General information

NPI: 1174431944
Provider Name (Legal Business Name): HARRIS FAMILY GROUP LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

708 CEDARBROOK DR
ROCKY MOUNT NC
27803-1905
US

IV. Provider business mailing address

708 CEDARBROOK DR
ROCKY MOUNT NC
27803-1905
US

V. Phone/Fax

Practice location:
  • Phone: 252-373-2631
  • Fax:
Mailing address:
  • Phone: 252-373-2631
  • 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

VIII. Authorized Official

Name: LAWRENCE DANIELS
Title or Position: DIRECTOR
Credential:
Phone: 252-373-2631