Provider Demographics
NPI:1538487574
Name:ROUSE GROUP HOME II INC
Entity Type:Organization
Organization Name:ROUSE GROUP HOME II INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-427-0609
Mailing Address - Street 1:PO BOX 327
Mailing Address - Street 2:
Mailing Address - City:STONEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27048-0327
Mailing Address - Country:US
Mailing Address - Phone:336-427-0609
Mailing Address - Fax:336-427-2929
Practice Address - Street 1:1921 BOULEVARD ST STE C
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-4560
Practice Address - Country:US
Practice Address - Phone:336-547-0665
Practice Address - Fax:336-427-2929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-14
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities