Organization
ROUSE'S GROUP HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA RENEE ROUSE (ADMINISTRATOR)
(336) 427-0609
Entity
Organization
Contact information
Practice address
5949 NC 135, STONEVILLE, NC 27048-8479
(336) 427-8562
(336) 427-2978
Mailing address
5949 NC 135, STONEVILLE, NC 27048-8479
(336) 427-2532
(336) 427-2978
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
MHL-079-004
NC
315P00000X
Intellectual Disabilities Intermediate Care Facility
MHL-079-047
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
340611X
—
NC
05
—
3406301
—
NC
Enumeration date
01/29/2007
Last updated
09/10/2015
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