Provider Demographics
NPI:1487848990
Name:CABARRUS COUNTY GROUP HOMES
Entity Type:Organization
Organization Name:CABARRUS COUNTY GROUP HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GINGER
Authorized Official - Middle Name:
Authorized Official - Last Name:POPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-855-0004
Mailing Address - Street 1:PO BOX 1197
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28026-1197
Mailing Address - Country:US
Mailing Address - Phone:704-855-0004
Mailing Address - Fax:704-855-0045
Practice Address - Street 1:1201 CHIPOLA RD
Practice Address - Street 2:
Practice Address - City:KANNAPOLIS
Practice Address - State:NC
Practice Address - Zip Code:28083-6325
Practice Address - Country:US
Practice Address - Phone:704-932-4172
Practice Address - Fax:704-855-0045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
NCMHL-013-084320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities