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General NPI Number Information
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NPI Number | 1730576992
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Entity Type | Organization
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Legal Business Name | HARRISON GROUP HOMES LLC
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Dates
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Enumeration Date | 04/24/2015
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Last Update Date | 04/24/2015
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Provider Practice Location Address
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Address Line | 2609 FERNBROOK RD
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City | RALEIGH
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State | NC
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Zip | 27610-3507
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Country | US
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Telephone | 919-301-8044
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Fax | 919-615-3267
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Provider Business Mailing Address
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Address Line | 2609 FERNBROOK RD
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City | RALEIGH
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State | NC
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Zip | 27610-3507
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Country | US
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Telephone | 919-301-8044
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Fax | 919-615-3267
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. UCHENNA HARRISON ENYINNAYA
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Credential |
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Telephone | 919-301-8044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | MHL-092-899
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License Number State | NC
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