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General NPI Number Information
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NPI Number | 1669190989
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Entity Type | Organization
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Legal Business Name | THE WILLIAMS HOUSE
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Dates
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Enumeration Date | 08/22/2022
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Last Update Date | 08/22/2022
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Provider Practice Location Address
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Address Line | 1129 HORSESHOE RD
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City | ELIZABETH CITY
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State | NC
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Zip | 27909-8507
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Country | US
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Telephone | 252-202-2711
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Fax |
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Provider Business Mailing Address
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Address Line | 102 WINDFIELD DR
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City | ELIZABETH CITY
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State | NC
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Zip | 27909-6244
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Country | US
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Telephone | 252-202-2711
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Fax |
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Authorized Official
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Title or Position | CO-OWNER / ADMINISTRATOR
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Name | JERAMY B WILLIAMS
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Credential |
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Telephone | 225-220-2271
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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 |
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License Number State |
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