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General NPI Number Information
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NPI Number | 1437974565
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Entity Type | Organization
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Legal Business Name | TRU FAMILY CARE HOME LLC
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Dates
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Enumeration Date | 11/22/2024
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 706 BREEDERS CUP DR
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City | WHITSETT
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State | NC
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Zip | 27377-8008
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Country | US
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Telephone | 336-512-1017
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Fax |
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Provider Business Mailing Address
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Address Line | 706 BREEDERS CUP DR
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City | WHITSETT
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State | NC
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Zip | 27377-8008
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Country | US
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Telephone | 336-512-1017
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. LEWIS MURDOCK
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Credential |
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Telephone | 336-260-3453
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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Taxonomy #2
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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Taxonomy #4
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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 |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #9
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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 |
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