Provider Demographics
NPI:1760529572
Name:THE SHEPARD'S JOY INC
Entity Type:Organization
Organization Name:THE SHEPARD'S JOY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:CAMPBELL
Authorized Official - Last Name:SHEPARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-244-2388
Mailing Address - Street 1:583 OLD LANDFILL RD
Mailing Address - Street 2:
Mailing Address - City:VANCEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28586-8655
Mailing Address - Country:US
Mailing Address - Phone:252-244-2388
Mailing Address - Fax:252-244-0088
Practice Address - Street 1:583 OLD LANDFILL RD
Practice Address - Street 2:
Practice Address - City:VANCEBORO
Practice Address - State:NC
Practice Address - Zip Code:28586-8655
Practice Address - Country:US
Practice Address - Phone:252-244-2388
Practice Address - Fax:252-244-0088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3278251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC055102OtherDHHS
NC6601442Medicaid