Provider Demographics
NPI:1861569055
Name:HOUSE OF CARE, INC.
Entity type:Organization
Organization Name:HOUSE OF CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:OGO
Authorized Official - Middle Name:A
Authorized Official - Last Name:EMODI-ONWUKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-493-6871
Mailing Address - Street 1:3500 WESTGATE DR
Mailing Address - Street 2:SUITE 303
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-2567
Mailing Address - Country:US
Mailing Address - Phone:919-493-6871
Mailing Address - Fax:919-493-6878
Practice Address - Street 1:3500 WESTGATE DR
Practice Address - Street 2:SUITE 303
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-2567
Practice Address - Country:US
Practice Address - Phone:919-493-6871
Practice Address - Fax:919-493-6878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7804763Medicaid
NC3409340Medicaid
NC8300547Medicaid