HOUSE OF JABEZ LLC (NPI# 1376757252) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376757252 |
| Entity Type | Organization |
| Organization Name | HOUSE OF JABEZ LLC |
| Practice Address |
203 Dock Street Fremont NC 27830-0662 |
| Mailing Address |
1516 A N. William Street Goldsboro NC 27530-1616 |
| Practice Telephone | 9192421296 |
| Mailing Telephone | 9196481190 |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. CLYDE RANDOLPH WILKINS (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 19192426115 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | MHL 096-195 | NC | Residential Treatment Facilities |
| Street Address |
203 DOCK STREET |
| City | FREMONT |
| State | NC |
| Zip Code | 27830-0662 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881724342 | Fremont Rest Center | Assisted Living Facility | 300 South Street, Fremont, NC 27830 | 2007-03-06 |
| 1275676561 | B & J Rest Villa | Assisted Living Facility | 305 South Vance Street, Fremont, NC 27830 | 2007-02-15 |
| 1407887862 | Jesse A Blackman, Md, Pa | Family Medicine | 109 S. Sycamore Street, Fremont, NC 27830 | 2006-07-05 |
| 1356484612 | B & J Rest Villa | Assisted Living Facility | 305 South Vance Street, Fremont, NC 27830 | 2007-02-15 |
| 1598384257 | Jessica Lynn Polk | Registered Nurse | 302 S Dock St, Fremont, NC 27830-2783 | 2020-04-13 |
| 1508243098 | Don Sin Dmd II Pa | Dentist | 102 S Sycamore St, Fremont, NC 27830-8709 | 2015-05-04 |
| 1174744270 | Calvin Scott Fuller | Dentist | 102 S. Sycamore St., 102 S. Sycamore St., Fremont, NC 27830-8709 | 2007-05-02 |
| 1992804587 | Joseph Ray Warren Jr. | Physician Assistant | 109 S Sycamore St, Fremont, NC 27830-8710 | 2006-09-21 |
| 1679718316 | Goshen Medical Center, Inc. | Clinic/Center | 109 S Sycamore St, Fremont, NC 27830-8710 | 2008-12-10 |
| 1093800328 | April Delyn Holland | Speech-Language Pathologist | 2092 Nc Highway 222 W, Fremont, NC 27830-9029 | 2006-10-03 |
| Find all providers in zip 27830 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265835987 | Sohumtech Inc | Community Based Residential Treatment Facility, Mental Illness | 5438 Shattuck Ave, Fremont, CA 94555-2931 | 2014-10-08 |
| 1770998874 | Acuharmony Inc | Community Based Residential Treatment Facility, Mental Illness | 40900 Fremont Blvd Ste C2, Fremont, CA 94538-4361 | 2014-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366041667 | Jalisa Jackson | Community Based Residential Treatment Facility, Mental Illness | 11413 Mangla Dr, Charlotte, NC 28214-8885 | 2020-10-19 |
| 1245837061 | Bliss Haven Group LLC | Community Based Residential Treatment Facility, Mental Illness | 2442 Sandhurst Ct, Gastonia, NC 28054-2738 | 2020-10-05 |
| 1386259265 | Nevaehs Caring Hands | Community Based Residential Treatment Facility, Mental Illness | 2509 Dalton Rd, Rocky Mount, NC 27803-4721 | 2020-09-09 |
| 1588279442 | C & C Homecare, LLC | Community Based Residential Treatment Facility, Mental Illness | 5119 Holdens Cross Rd, Wilson, NC 27893-8253 | 2020-09-08 |
| 1801409859 | Destiny & Miracle LLC | Community Based Residential Treatment Facility, Mental Illness | 1024 Houston St, Gastonia, NC 28052-1632 | 2020-08-28 |
| 1699329433 | Fresh Start Today Inc | Community Based Residential Treatment Facility, Mental Illness | 3707 Roseheim Ct, Greensboro, NC 27405-4867 | 2019-07-30 |
| 1003460833 | Care-in-full | Community Based Residential Treatment Facility, Mental Illness | 1338 Sharp Ridge Rd, Greensboro, NC 27406-8597 | 2019-07-30 |
| 1366001976 | Foundation of Hope, Inc. | Community Based Residential Treatment Facility, Mental Illness | 119 Grice Road, Chadbourn, NC 28431-6709 | 2019-06-07 |
| 1558927590 | Tall Family Services, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1915 Hasty Rd, Marshville, NC 28103-0029 | 2019-05-15 |
| 1174187868 | Stepping Stone Services Inc. | Community Based Residential Treatment Facility, Mental Illness | 2720 White Oak Ln, Kannapolis, NC 28083-7256 | 2019-04-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.