Organization
GRANVILLE COUNTY GROUP HOMES, INC.
Active
Other names
Granville ICF group Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SKIP SKINNER (DIRECTOR)
(252) 438-6700
Entity
Organization
Contact information
Practice address
5509 DORSEY RD, OXFORD, NC 27565-8309
(919) 528-4610
Mailing address
5509 DORSEY RD, OXFORD, NC 27565-8309
(919) 528-4610
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
MHL039002
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3406229
—
NC
Enumeration date
06/07/2007
Last updated
08/22/2020
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