Provider Demographics
NPI:1669629366
Name:HELEN'S HOUSE, INC
Entity Type:Organization
Organization Name:HELEN'S HOUSE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DELOACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-512-6760
Mailing Address - Street 1:6111 CONAWAY DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-2700
Mailing Address - Country:US
Mailing Address - Phone:910-512-6760
Mailing Address - Fax:
Practice Address - Street 1:62 MCCALL CIRCLE
Practice Address - Street 2:
Practice Address - City:TARHEEL
Practice Address - State:NC
Practice Address - Zip Code:28392
Practice Address - Country:US
Practice Address - Phone:910-512-6760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-25
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children