Provider Demographics
NPI:1407077639
Name:RAPPS GROUP HOME, INC
Entity Type:Organization
Organization Name:RAPPS GROUP HOME, INC
Other - Org Name:RAPPS RESIDENTIAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FACILITY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOGANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-974-4980
Mailing Address - Street 1:132 WILEY ST
Mailing Address - Street 2:
Mailing Address - City:CANDOR
Mailing Address - State:NC
Mailing Address - Zip Code:27229-9097
Mailing Address - Country:US
Mailing Address - Phone:910-974-4980
Mailing Address - Fax:910-974-7160
Practice Address - Street 1:132 WILEY ST
Practice Address - Street 2:
Practice Address - City:CANDOR
Practice Address - State:NC
Practice Address - Zip Code:27229-9097
Practice Address - Country:US
Practice Address - Phone:910-974-4980
Practice Address - Fax:910-974-7160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL062017320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6603690Medicaid