Provider Demographics
NPI:1043627623
Name:STREETS TO HOMES
Entity Type:Organization
Organization Name:STREETS TO HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-565-3747
Mailing Address - Street 1:202 E ARLINGTON BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5021
Mailing Address - Country:US
Mailing Address - Phone:252-565-3747
Mailing Address - Fax:252-360-4142
Practice Address - Street 1:202 E ARLINGTON BLVD STE D
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5021
Practice Address - Country:US
Practice Address - Phone:252-565-3747
Practice Address - Fax:252-565-0301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-16
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCBL006364-06-2014251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management