Provider Demographics
NPI:1427195213
Name:BARNES FAMILY CARE
Entity Type:Organization
Organization Name:BARNES FAMILY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SIMON
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:252-237-1832
Mailing Address - Street 1:1008 CORBETT AVE NE
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-1912
Mailing Address - Country:US
Mailing Address - Phone:252-237-1832
Mailing Address - Fax:252-237-1413
Practice Address - Street 1:1008 CORBETT AVE NE
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-1912
Practice Address - Country:US
Practice Address - Phone:252-237-1832
Practice Address - Fax:252-237-1413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7801376Medicaid
NC7804535Medicaid