Provider Demographics
NPI:1013312446
Name:THE JANICE MAE HAWKINS FOUNDATION, INC.
Entity Type:Organization
Organization Name:THE JANICE MAE HAWKINS FOUNDATION, INC.
Other - Org Name:S & S SPOONRIDGE PSR PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:LYONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-864-3426
Mailing Address - Street 1:3359 GABLES DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28301-7648
Mailing Address - Country:US
Mailing Address - Phone:910-864-3426
Mailing Address - Fax:910-491-6803
Practice Address - Street 1:3359 GABLES DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28301-7648
Practice Address - Country:US
Practice Address - Phone:910-864-3426
Practice Address - Fax:910-491-6803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-28
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-026-953251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services