Healthcare Provider Details

I. General information

NPI: 1164578886
Provider Name (Legal Business Name): COLUMBUS GROUP HOMES, INC.
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

805 N FRANKLIN ST SUITE 5
WHITEVILLE NC
28472-2735
US

IV. Provider business mailing address

805 N FRANKLIN ST SUITE 5
WHITEVILLE NC
28472-2735
US

V. Phone/Fax

Practice location:
  • Phone: 910-640-1557
  • Fax: 910-640-0814
Mailing address:
  • Phone: 910-640-1557
  • Fax: 910-640-0814

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License NumberMHL024017
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License NumberMHL024014
License Number StateNC

VIII. Authorized Official

Name: SELENA ROWELL
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 910-640-1557