Provider Demographics
NPI:1730576992
Name:HARRISON GROUP HOMES LLC
Entity type:Organization
Organization Name:HARRISON GROUP HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:UCHENNA
Authorized Official - Middle Name:HARRISON
Authorized Official - Last Name:ENYINNAYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-301-8044
Mailing Address - Street 1:2609 FERNBROOK RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-3507
Mailing Address - Country:US
Mailing Address - Phone:919-301-8044
Mailing Address - Fax:919-615-3267
Practice Address - Street 1:2609 FERNBROOK RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-3507
Practice Address - Country:US
Practice Address - Phone:919-301-8044
Practice Address - Fax:919-615-3267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-24
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-092-899261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health