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Linda Shorts Home
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Jacksonville, North Carolina
NPI 1316003668

Linda Shorts Home is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Jacksonville, NC. Linda Shorts Home practices in Jacksonville, NC. The NPI Number for Linda Shorts Home is 1316003668 and holds a License No. MHL067026 (North Carolina).

The current practice location address for Linda Shorts Home is 106 Grantham Ln, Jacksonville, NC and can be reached out via phone at 910-455-4480. You can also correspond with Linda Shorts Home through the mailing address at 180 COASTAL LN, JACKSONVILLE, NC - 28546-6761 (mailing address contact number: 910-455-6724).

Location: 106 Grantham Ln, Jacksonville, NC, 28546-6761
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1316003668
Provider Name
Linda Shorts Home
Credential
Provider Entity Type
Organization
Address
106 Grantham Ln, Jacksonville, NC, 28546-6761
Phone Number
910-455-4480
Fax Number
Provider Enumeration Date
12/29/2006
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
3408956 05 NC
institution
Provider Business Practice Location Address Details
Address
106 Grantham Ln
City
Jacksonville
State
North Carolina
Zip
28546-8150
Phone Number
910-455-4480
Fax Number
person
Provider Business Mailing Address Details
Address
106 Grantham Ln
City
Jacksonville
State
North Carolina
Zip
28546-8150
Phone Number
910-455-4480
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Developmental Disabilities
Taxonomy
261QD1600X
License No.
MHL067026 (North Carolina)
Definition
An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).
person
Provider's Taxonomy Details 2
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
MHL067026 (North Carolina)
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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