Provider Demographics
NPI:1578165346
Name:SAMARITAN HOUSING FOUNDATION, INC
Entity Type:Organization
Organization Name:SAMARITAN HOUSING FOUNDATION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:CLEMENTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-234-0408
Mailing Address - Street 1:17001 SEARSTONE DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-8385
Mailing Address - Country:US
Mailing Address - Phone:919-234-0408
Mailing Address - Fax:
Practice Address - Street 1:17001 SEARSTONE DR
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-8385
Practice Address - Country:US
Practice Address - Phone:919-234-0408
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0636OtherDHSR LICENSE
NC070310OtherDHSR FACILITY ID