Provider Demographics
NPI:1730372525
Name:BAPTIST CHILDREN'S HOMES OF NC, INC.
Entity type:Organization
Organization Name:BAPTIST CHILDREN'S HOMES OF NC, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR OF PROGRAM DEVELOPMENT
Authorized Official - Prefix:MS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-474-1250
Mailing Address - Street 1:PO BOX 338
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27360-4514
Mailing Address - Country:US
Mailing Address - Phone:336-474-1250
Mailing Address - Fax:336-472-4605
Practice Address - Street 1:1091 OAKTRAIL LN
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-0989
Practice Address - Country:US
Practice Address - Phone:919-258-5437
Practice Address - Fax:919-258-5617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-24
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X, 320800000X
NCB01512322D00000X
NCB01154322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No251S00000XAgenciesCommunity/Behavioral Health
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness