Provider Demographics
NPI:1932341336
Name:RACHEL'S HOUSE
Entity Type:Organization
Organization Name:RACHEL'S HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:HILL
Authorized Official - Last Name:MEBANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-794-1555
Mailing Address - Street 1:103-B KING ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:EDENTON
Mailing Address - State:NC
Mailing Address - Zip Code:27932-0133
Mailing Address - Country:US
Mailing Address - Phone:252-482-3001
Mailing Address - Fax:252-482-3387
Practice Address - Street 1:103 E KING ST
Practice Address - Street 2:SUITE B
Practice Address - City:EDENTON
Practice Address - State:NC
Practice Address - Zip Code:27932-1957
Practice Address - Country:US
Practice Address - Phone:252-482-3001
Practice Address - Fax:252-482-3387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-31
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC=========Medicaid