Provider Demographics
NPI:1851619258
Name:HHDM, INC.
Entity Type:Organization
Organization Name:HHDM, INC.
Other - Org Name:JOHNSTON RECOVERY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:DAVISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-359-1699
Mailing Address - Street 1:1699 OLD US HIGHWAY 70 WEST
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520
Mailing Address - Country:US
Mailing Address - Phone:919-359-1699
Mailing Address - Fax:919-359-1697
Practice Address - Street 1:1699 OLD US 70 HWY W
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-6566
Practice Address - Country:US
Practice Address - Phone:919-359-1699
Practice Address - Fax:919-359-1697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-10
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL051177261QM2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCPENDINGMedicaid