Organization
BENJAMIN HOUSE, INC.
Active
Other names
Benjamin House Community Services
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JAYNE JONES HOLLOWELL BA (DIRECTOR)
(252) 331-7731
Entity
Organization
Contact information
Practice address
848 FOREST PARK ROAD, ELIZABETH CITY, NC 27909-5461
(252) 331-7731
(252) 331-1777
Mailing address
PO BOX 757, ELIZABETH CITY, NC 27907-0757
(252) 331-7731
(252) 331-1777
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
3408242
NC
311ZA0620X
Adult Care Home Facility
MHL-070-039
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408242
—
NC
Enumeration date
12/12/2006
Last updated
03/18/2016
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