Provider Demographics
NPI:1265528632
Name:HOKE CO ASSOCIATION FOR DEVELOP DISABLED INC.
Entity type:Organization
Organization Name:HOKE CO ASSOCIATION FOR DEVELOP DISABLED INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JODI
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-875-5074
Mailing Address - Street 1:305 WOOLEY ST
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-3236
Mailing Address - Country:US
Mailing Address - Phone:910-875-5074
Mailing Address - Fax:910-875-7694
Practice Address - Street 1:305 WOOLEY ST
Practice Address - Street 2:
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-3236
Practice Address - Country:US
Practice Address - Phone:910-875-5074
Practice Address - Fax:910-875-7694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC47000035251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8300027Medicaid