Organization
GROUP HOME HOLDINGS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY JOHNS BENSON (DIRECTOR OF BILLING)
(336) 553-5946
Entity
Organization
Contact information
Practice address
9502 N FLORIDA AVE, TAMPA, FL 33612-7910
(919) 390-2980
Mailing address
6531 MERIDIEN DR STE 103, RALEIGH, NC 27616-3213
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
04/16/2021
Last updated
04/16/2021
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