Provider Demographics
NPI:1922761972
Name:THE VAUGHN FAM-HOME
Entity Type:Organization
Organization Name:THE VAUGHN FAM-HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:0WNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:VAUGHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-288-2829
Mailing Address - Street 1:PO BOX 1672
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27533-1672
Mailing Address - Country:US
Mailing Address - Phone:919-288-2829
Mailing Address - Fax:919-735-8886
Practice Address - Street 1:105 NEIL ST
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-1525
Practice Address - Country:US
Practice Address - Phone:919-394-8130
Practice Address - Fax:919-735-8886
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE VAUGHN FAM HOME
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-10-18
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health