Provider Demographics
NPI:1669529228
Name:HERBERT REID HOME INC
Entity type:Organization
Organization Name:HERBERT REID HOME INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HERBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:REID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-961-1922
Mailing Address - Street 1:PO BOX 1057
Mailing Address - Street 2:HERBERT REID HOME INC
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540
Mailing Address - Country:US
Mailing Address - Phone:919-961-1922
Mailing Address - Fax:919-363-5312
Practice Address - Street 1:3733 HERITAGE MEADOW LANE
Practice Address - Street 2:HERBERT REID HOME INC
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540
Practice Address - Country:US
Practice Address - Phone:919-961-1922
Practice Address - Fax:919-363-5312
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HERBERT REID HOME INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-05
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC092399101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3409159Medicaid