Provider Demographics
NPI:1609046028
Name:ADRIENNE'S HOUSE
Entity Type:Organization
Organization Name:ADRIENNE'S HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GLOVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-478-1983
Mailing Address - Street 1:PO BOX 592
Mailing Address - Street 2:
Mailing Address - City:LOUISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:27549-0592
Mailing Address - Country:US
Mailing Address - Phone:252-478-1983
Mailing Address - Fax:252-478-6146
Practice Address - Street 1:408 BIRCH DR
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-7732
Practice Address - Country:US
Practice Address - Phone:252-478-1983
Practice Address - Fax:252-478-6146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC096205311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home