Organization
ROUSE'S GROUP HOME INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBRA RENE ROUSE (ADMINISTRATOR)
(336) 427-0609
Entity
Organization
Contact information
Practice address
5820 NC 135, STONEVILLE, NC 27048-8478
(336) 427-3373
(336) 427-2929
Mailing address
PO BOX 16, STONEVILLE, NC 27048-0016
(336) 427-3373
(336) 427-2929
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
MHL-079-047
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
340611X
—
NC
Enumeration date
01/18/2013
Last updated
02/20/2013
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