# SHUFFORD GROUP HOME

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639338825
- **Authorized official:** ANNETTE LASHONDA SHUFFORD (OWNER)
- **Authorized official phone:** (919) 986-0053

## Contact information

- **Practice address:** 5164 LIMEWOOD ST, KNIGHTDALE, NC 27545-8138
- **Practice address phone:** (919) 986-0053
- **Practice address fax:** (919) 231-0426
- **Mailing address:** 2905 DEEDA CT, RALEIGH, NC 27610-5461

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320800000X | Mental Illness Community Based Residential Treatment Facility | MHL-092-709 | NC | — |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | MHL-092-709 | NC | Yes |

## Other

- **Enumeration date:** 06/03/2008
- **Last updated:** 06/19/2008