Organization
WHITFIELD HOMES INC.
Active
Other names
Whitfield Homes ASP
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PERCY WILSON GOODE BS (OWNER PRESIDENT)
(910) 592-5462
Entity
Organization
Contact information
Practice address
202 SAMPSON ST, 1, CLINTON, NC 28328-2864
(910) 592-5462
(910) 590-2754
Mailing address
202 SAMPSON ST, 1, CLINTON, NC 28328-2864
(910) 592-5462
(910) 590-2754
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
MHL-026-736
NC
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL-082-040
NC
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
MHL-082-045
NC
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
MHL-082-054
NC
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
MHL-082-045
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3409425
CAP PROVIDER
NC
05
—
8301367B
—
NC
Enumeration date
10/31/2006
Last updated
09/05/2007
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