Provider Demographics
NPI:1518478957
Name:HOME AWAY FROM HOME, INC.
Entity Type:Organization
Organization Name:HOME AWAY FROM HOME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:PAULETTE
Authorized Official - Last Name:SPEIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-539-5714
Mailing Address - Street 1:1723 MEADOWBROOK LANE W.
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27803
Mailing Address - Country:US
Mailing Address - Phone:252-296-9459
Mailing Address - Fax:
Practice Address - Street 1:1723 MEADOWBROOK LANE W.
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893
Practice Address - Country:US
Practice Address - Phone:252-296-9459
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-12
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No172A00000XOther Service ProvidersDriverGroup - Single Specialty
No251B00000XAgenciesCase ManagementGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive Care