Provider Demographics
NPI:1841655453
Name:JOURNEYS HEALTHCARE
Entity type:Organization
Organization Name:JOURNEYS HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRSEIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HAYNES
Authorized Official - Middle Name:ALMOND
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:910-840-7481
Mailing Address - Street 1:515 CARVER MOORE RD
Mailing Address - Street 2:
Mailing Address - City:LAKE WACCAMAW
Mailing Address - State:NC
Mailing Address - Zip Code:28450-9713
Mailing Address - Country:US
Mailing Address - Phone:910-840-7481
Mailing Address - Fax:
Practice Address - Street 1:515 CARVER MOORE RD
Practice Address - Street 2:
Practice Address - City:LAKE WACCAMAW
Practice Address - State:NC
Practice Address - Zip Code:28450-9713
Practice Address - Country:US
Practice Address - Phone:910-840-7481
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-24
Last Update Date:2015-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC146393315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities