Provider Demographics
NPI:1346314796
Name:THE METHODIST HOME FOR CHILDREN, IN.C
Entity Type:Organization
Organization Name:THE METHODIST HOME FOR CHILDREN, IN.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF QUALITY IMPROVEMENT
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:FRANKFORT-WINNINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-754-3638
Mailing Address - Street 1:1041 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27605-1259
Mailing Address - Country:US
Mailing Address - Phone:919-754-3638
Mailing Address - Fax:919-755-1833
Practice Address - Street 1:5400 N HILLS DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-5909
Practice Address - Country:US
Practice Address - Phone:919-782-8389
Practice Address - Fax:919-782-8387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 251S00000X, 253J00000X
NCMHL092518320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253J00000XAgenciesFoster Care Agency
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6106014Medicaid
NC6005648Medicaid
NC6111853Medicaid
NC6603464Medicaid