MEDICARE: HINTONS GROUP HOME

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
2	320800000X	Mental Illness Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1538895768
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HINTONS GROUP HOME

Provider Business Mailing Address
First Line	:	4010 WILD OLIVE DR
Second Line	:
City	:	HUNTERSVILLE
State	:	NC
Zip	:	28078-3968
Country	:	US
Telephone Number	:	125-220-5734
Fax Number	:

Provider Business Practice Location Address
First Line	:	2728 S RIDGE AVE
Second Line	:
City	:	CONCORD
State	:	NC
Zip	:	28025-2854
Country	:	US
Telephone Number	:	252-205-7344
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	SPENCER HINTON
Credential	:
Telephone Number	:	252-205-7344

Provider Enumeration Date	:	07/29/2022
Last Update Date	:	12/23/2024

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Directions to “HINTONS GROUP HOME ” Practice Location

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