Provider Demographics
NPI:1821741281
Name:MORRIS GROUP HOME INC
Entity Type:Organization
Organization Name:MORRIS GROUP HOME INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARCELLIUS
Authorized Official - Middle Name:DION
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-369-2882
Mailing Address - Street 1:1206 PIONEER RD
Mailing Address - Street 2:
Mailing Address - City:MANGONIA PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2241
Mailing Address - Country:US
Mailing Address - Phone:770-369-2882
Mailing Address - Fax:
Practice Address - Street 1:1206 PIONEER RD
Practice Address - Street 2:
Practice Address - City:MANGONIA PARK
Practice Address - State:FL
Practice Address - Zip Code:33407-2241
Practice Address - Country:US
Practice Address - Phone:770-369-2882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-26
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310500000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Mental Illness