Provider Demographics
NPI:1669190989
Name:THE WILLIAMS HOUSE
Entity type:Organization
Organization Name:THE WILLIAMS HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER / ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JERAMY
Authorized Official - Middle Name:B
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-220-2271
Mailing Address - Street 1:102 WINDFIELD DR
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-6244
Mailing Address - Country:US
Mailing Address - Phone:252-202-2711
Mailing Address - Fax:
Practice Address - Street 1:1129 HORSESHOE RD
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-8507
Practice Address - Country:US
Practice Address - Phone:252-202-2711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home