Healthcare Provider Details
I. General information
NPI: 1760217848
Provider Name (Legal Business Name): SARACHEL HOMES NC INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/06/2024
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
265 CARTER CIR
WINSTON SALEM NC
27106-4807
US
IV. Provider business mailing address
10721 JOHN PRICE RD STE A8
CHARLOTTE NC
28273-0326
US
V. Phone/Fax
- Phone: 336-529-4569
- Fax:
- Phone: 980-430-3669
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 320800000X |
| Taxonomy | Mental Illness Community Based Residential Treatment Facility |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 320900000X |
| Taxonomy | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MIA
TANEE
HATTEN
Title or Position: DIRECTOR
Credential:
Phone: 704-993-7388