Provider Demographics
NPI:1134320070
Name:CARRHILL HOME LLC
Entity Type:Organization
Organization Name:CARRHILL HOME LLC
Other - Org Name:CARRHILL HOME #2
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:J
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:0
Authorized Official - Phone:919-688-7721
Mailing Address - Street 1:603 DUNBAR ST
Mailing Address - Street 2:P 0ST OFFICE BOX 524
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-4524
Mailing Address - Country:US
Mailing Address - Phone:919-688-7721
Mailing Address - Fax:919-688-7721
Practice Address - Street 1:603 DUNBAR ST
Practice Address - Street 2:407 MOLINE STREET
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-4524
Practice Address - Country:US
Practice Address - Phone:919-688-7721
Practice Address - Fax:919-688-7721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL032196101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7805072Medicaid
NC7803659Medicaid