Guardian Care 1, 2, 3, 4, Changing Lives, Safe Haven,Bridge Of Hope

LBN: Spirit Of Excellence Community Outreach,Inc.
Guardian Care 1, 2, 3, 4, Changing Lives, Safe Haven,Bridge Of Hope is an health care organization with primary practice located at 123 Henderson Dr , Jacksonville NC 28540-5601. The organization recently has 9 registered licenses in different health care specialties including Agencies / Case Management, Agencies / Home Health, Agencies / Community/Behavioral Health, Ambulatory Health Care Facilities / Developmental Disabilities, Ambulatory Health Care Facilities / Adult Mental Health, Nursing & Custodial Care Facilities / Adult Care Home, Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness, Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, Residential Treatment Facilities / Psychiatric Residential Treatment Facility. Agencies / Home Health is the primary health care specialty. Spirit Of Excellence Community Outreach,Inc. can be contacted via phone (910) 939-4663, or through Fludd, Helen Delorise via phone (910) 382-6595.

Contact Information

Primary practice address
123 Henderson Dr Jacksonville NC 28540-5601
Phone: (910) 939-4663
Fax: (910) 939-5079
Website:
Map and Directions
Authorized official contact:
Name: Fludd, Helen Delorise
Phone: (910) 382-6595

Health care specialties

SpecialtyCodeLicense #State
Agencies / Case Management 251B00000X
Agencies / Home Health 251E00000X
Agencies / Community/Behavioral Health 251S00000X
Ambulatory Health Care Facilities / Developmental Disabilities 261QD1600X
Ambulatory Health Care Facilities / Adult Mental Health 261QM0850X
Nursing & Custodial Care Facilities / Adult Care Home 311ZA0620X
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness 320800000X
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320900000X
Residential Treatment Facilities / Psychiatric Residential Treatment Facility 323P00000X MHL-067-164 North Carolina

Profile Details

NPI number 1942333240
LBN Legal business name Spirit Of Excellence Community Outreach,Inc.
DBA Doing business as Guardian Care 1, 2, 3, 4, Changing Lives, Safe Haven,Bridge Of Hope
Authorized official Fludd, Helen Delorise
Entity Organization
Organization subpart 1 No
Enumeration date Mar 14th, 2007
Last updated Feb 2nd, 2015 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942333240 NPPES
North Carolina MEDICAID 3418119
North Carolina MEDICAID 8301352
North Carolina MEDICAID 8301352G
North Carolina MEDICAID 3408311
North Carolina MEDICAID 6602173
North Carolina Other 001GM
North Carolina Other 009EJ
North Carolina MEDICAID 6006360
North Carolina MEDICAID 7805061
North Carolina MEDICAID 6601227
North Carolina MEDICAID 8301352B

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