Organization
HARRIS HOMES AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM HARRIS (DIRECTOR OWNER)
(910) 554-1355
Entity
Organization
Contact information
Practice address
104 STERLING RD, JACKSONVILLE, NC 28546-8330
(910) 353-0124
Mailing address
104 STERLING RD, JACKSONVILLE, NC 28546-8330
(910) 353-0124
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
MHL-067-143
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301742
—
NC
Enumeration date
03/27/2007
Last updated
08/22/2020
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