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General NPI Number Information
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NPI Number | 1144669409
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Entity Type | Organization
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Legal Business Name | MCDANIEL HOMES,LLC
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Dates
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Enumeration Date | 06/20/2013
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Last Update Date | 12/12/2019
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Provider Practice Location Address
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Address Line | 3830 MCGHEES MILL RD
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City | SEMORA
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State | NC
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Zip | 27343-9199
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Country | US
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Telephone | 336-599-7727
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Fax | 336-599-8186
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Provider Business Mailing Address
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Address Line | PO BOX 1636
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City | ROXBORO
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State | NC
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Zip | 27573-1636
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Country | US
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Telephone | 336-599-1073
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Fax | 336-599-8186
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. PEGGY DAVIS- MCDANIEL
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Credential |
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Telephone | 336-599-1073
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | MHL -073-041
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License Number State | NC
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Taxonomy #2
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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-073-041
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License Number State | NC
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