Provider Demographics
NPI:1598807794
Name:BUILDING JOY IN HEALTHCARE GROUP HOME CORP
Entity Type:Organization
Organization Name:BUILDING JOY IN HEALTHCARE GROUP HOME CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-257-7236
Mailing Address - Street 1:1830 EICHELBERGER DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-6257
Mailing Address - Country:US
Mailing Address - Phone:910-257-7236
Mailing Address - Fax:910-485-4005
Practice Address - Street 1:726 RAMSEY ST SUITE 12
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28301-4705
Practice Address - Country:US
Practice Address - Phone:910-485-4005
Practice Address - Fax:910-485-4005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL026725320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6604302Medicaid