Provider Demographics
NPI: | 1437974565 |
---|---|
Name: | TRU FAMILY CARE HOME LLC |
Entity type: | Organization |
Organization Name: | TRU FAMILY CARE HOME LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | LEWIS |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | MURDOCK |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 336-260-3453 |
Mailing Address - Street 1: | 706 BREEDERS CUP DR |
Mailing Address - Street 2: | |
Mailing Address - City: | WHITSETT |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 27377-8008 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 336-512-1017 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 706 BREEDERS CUP DR |
Practice Address - Street 2: | |
Practice Address - City: | WHITSETT |
Practice Address - State: | NC |
Practice Address - Zip Code: | 27377-8008 |
Practice Address - Country: | US |
Practice Address - Phone: | 336-512-1017 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2024-11-22 |
Last Update Date: | 2024-12-10 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 320600000X | Residential Treatment Facilities | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
No | 251S00000X | Agencies | Community/Behavioral Health | |
No | 3104A0625X | Nursing & Custodial Care Facilities | Assisted Living Facility | Assisted Living, Mental Illness |
No | 311ZA0620X | Nursing & Custodial Care Facilities | Custodial Care Facility | Adult Care Home |
No | 320900000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
No | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness | |
No | 322D00000X | Residential Treatment Facilities | Residential Treatment Facility, Emotionally Disturbed Children | |
No | 385H00000X | Respite Care Facility | Respite Care | |
No | 385HR2060X | Respite Care Facility | Respite Care | Respite Care, Intellectual and/or Developmental Disabilities, Child |