Provider Demographics
NPI:1235467333
Name:MD HOMES INC
Entity Type:Organization
Organization Name:MD HOMES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:S
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:BSN RN
Authorized Official - Phone:908-305-3143
Mailing Address - Street 1:740 GREENVILLE BLVD
Mailing Address - Street 2:STE 400-287
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5135
Mailing Address - Country:US
Mailing Address - Phone:252-412-0353
Mailing Address - Fax:252-822-0142
Practice Address - Street 1:708 W 14TH AVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-3083
Practice Address - Country:US
Practice Address - Phone:252-412-0353
Practice Address - Fax:252-822-0142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-01
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC320600000X, 320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities