Provider Demographics
NPI:1144669409
Name:MCDANIEL HOMES,LLC
Entity type:Organization
Organization Name:MCDANIEL HOMES,LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:DAVIS-
Authorized Official - Last Name:MCDANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-599-1073
Mailing Address - Street 1:PO BOX 1636
Mailing Address - Street 2:
Mailing Address - City:ROXBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27573-1636
Mailing Address - Country:US
Mailing Address - Phone:336-599-1073
Mailing Address - Fax:336-599-8186
Practice Address - Street 1:3830 MCGHEES MILL RD
Practice Address - Street 2:
Practice Address - City:SEMORA
Practice Address - State:NC
Practice Address - Zip Code:27343-9199
Practice Address - Country:US
Practice Address - Phone:336-599-7727
Practice Address - Fax:336-599-8186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-20
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL -073-041311ZA0620X
NCMHL-073-041320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home