Provider Demographics
NPI:1447789243
Name:A PLACE LIKE HOME LLC
Entity Type:Organization
Organization Name:A PLACE LIKE HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:BROOKE
Authorized Official - Last Name:MANESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-343-3726
Mailing Address - Street 1:707 KIDD DR
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27217-1850
Mailing Address - Country:US
Mailing Address - Phone:336-270-6271
Mailing Address - Fax:
Practice Address - Street 1:707 KIDD DR
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27217-1850
Practice Address - Country:US
Practice Address - Phone:336-270-6271
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness