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General NPI Number Information
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NPI Number | 1578455622
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Entity Type | Organization
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Legal Business Name | CORENIA HOMES, LLC
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Dates
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Enumeration Date | 07/15/2025
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 2201 SMITH HARBOUR DR
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City | DENVER
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State | NC
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Zip | 28037-8086
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Country | US
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Telephone | 980-334-1848
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Fax |
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Provider Business Mailing Address
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Address Line | 531 BRENTWOOD ROAD PMB #156
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City | DENVER
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State | NC
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Zip | 28037-0269
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MS. CONSTANCE GLASS
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Credential |
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Telephone | 980-334-1848
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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