# VIRINGIA'S GROUP HOME

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

## Provider details

- **NPI number:** 1811607583
- **Authorized official:** SHEMIKA VERBAL (DIRECTOR)
- **Authorized official phone:** (910) 986-0475

## Contact information

- **Practice address:** 7105 NC HWY 210 S, AUTRYVILLE, NC 28318-7683
- **Practice address phone:** (910) 986-0475
- **Mailing address:** 28680 N TURNPIKE RD, WAGRAM, NC 28396-9032
- **Mailing address phone:** (910) 986-0475

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |
| 320800000X | Mental Illness Community Based Residential Treatment Facility | — | NULL | — |

## Other

- **Enumeration date:** 12/02/2022
- **Last updated:** 01/10/2023