Provider Demographics
NPI:1124887344
Name:STRAIGHT TALK SUPPORT GROUP TRANSITIONAL HOUSE RESOURCE CENTER
Entity type:Organization
Organization Name:STRAIGHT TALK SUPPORT GROUP TRANSITIONAL HOUSE RESOURCE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BESSIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:ELMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:984-219-1001
Mailing Address - Street 1:1101 N MANGUM ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-1931
Mailing Address - Country:US
Mailing Address - Phone:984-219-1001
Mailing Address - Fax:984-219-1637
Practice Address - Street 1:1101 N MANGUM ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-1931
Practice Address - Country:US
Practice Address - Phone:984-219-1001
Practice Address - Fax:984-219-1637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesGroup - Multi-Specialty