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General NPI Number Information
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NPI Number | 1306461926
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Entity Type | Organization
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Legal Business Name | OUR HOME AT HOME
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Dates
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Enumeration Date | 06/09/2020
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Last Update Date | 04/23/2026
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Provider Practice Location Address
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Address Line | 316 BLACK ROCK SCHOOL RD
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City | CHERRYVILLE
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State | NC
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Zip | 28021-9544
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Country | US
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Telephone | 980-924-3476
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 37
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City | CHERRYVILLE
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State | NC
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Zip | 28021-0037
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Country | US
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Telephone | 980-925-3476
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Fax |
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Authorized Official
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Title or Position | ORGANIZER
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Name | CEARIRA S COWAN
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Credential |
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Telephone | 980-925-3476
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State | NULL
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | NULL
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