Organization
1ST & 10 GROUP HOME, INC. #2
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRIS CORNELIUS MCPHAIL (OWNER)
(910) 299-0099
Entity
Organization
Contact information
Practice address
6090 TURKEY HIGHWAY, TURKEY, NC 28393-9998
(910) 590-2034
(910) 299-0010
Mailing address
PO BOX 41, CLINTON, NC 28329-0041
(910) 299-0099
(910) 299-0010
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL082071
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6604227
—
NC
Enumeration date
07/31/2007
Last updated
03/28/2008
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us