Provider Demographics
NPI:1184878605
Name:GEORGE'S HOUSE, LLC
Entity type:Organization
Organization Name:GEORGE'S HOUSE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-291-1137
Mailing Address - Street 1:809 SELMA ST SW
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-4723
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:252-237-8395
Practice Address - Street 1:809 SELMA ST SW
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-4723
Practice Address - Country:US
Practice Address - Phone:252-237-8395
Practice Address - Fax:252-237-8395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-11
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0800011302311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home