Provider Demographics
NPI:1679708366
Name:SHARPE AND WILLIAMS FAMILY CARE HOME
Entity Type:Organization
Organization Name:SHARPE AND WILLIAMS FAMILY CARE HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPAUULDING
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:919-876-9352
Mailing Address - Street 1:4458 SNOWCREST LN
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-8839
Mailing Address - Country:US
Mailing Address - Phone:919-876-9352
Mailing Address - Fax:
Practice Address - Street 1:2740 NEW WALKERTOWN RD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27105-4818
Practice Address - Country:US
Practice Address - Phone:919-876-9352
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-25
Last Update Date:2009-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC034243320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness