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General NPI Number Information
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NPI Number | 1144366345
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Entity Type | Organization
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Legal Business Name | CHISHOLM HOMES
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 431 N SCIENTIFIC ST
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City | HIGH POINT
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State | NC
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Zip | 27260-4337
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Country | US
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Telephone | 336-887-2402
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Fax | 336-887-2403
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Provider Business Mailing Address
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Address Line | 431 N SCIENTIFIC ST
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City | HIGH POINT
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State | NC
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Zip | 27260-4337
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Country | US
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Telephone | 336-887-2402
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Fax | 336-887-2403
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. PENNY S CHISHOLM
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Credential |
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Telephone | 336-887-2402
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | MHL-041-776
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License Number State | NC
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