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William Thomas Gorham JR.
Emotionally Disturbed Childrens' Residential Treatment Facility in Greenville, North Carolina
NPI 1568230902

William Thomas Gorham JR. is a Emotionally Disturbed Childrens' Residential Treatment Facility based in Greenville, NC. William Thomas Gorham JR. practices in Greenville, NC. The NPI Number for William Thomas Gorham JR. is 1568230902 and holds a License No. (North Carolina).

The current practice location address for William Thomas Gorham JR. is 878 W Star St, Greenville, NC and can be reached out via phone at 252-417-6829.

Location: 878 W Star St, Greenville, NC, 27834-0844
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1568230902
Provider Name
William Thomas Gorham JR.
Credential
Provider Entity Type
Individual
Gender
Male
Address
878 W Star St, Greenville, NC, 27834-0844
Phone Number
252-417-6829
Fax Number
Provider Enumeration Date
12/14/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
878 W Star St
City
Greenville
State
North Carolina
Zip
27834-0844
Phone Number
252-417-6829
Fax Number
person
Provider Business Mailing Address Details
Address
878 W Star St
City
Greenville
State
North Carolina
Zip
27834-0844
Phone Number
252-417-6829
Fax Number
person
Provider's Taxonomy Details 1
Type
Agencies
Classification
Community/Behavioral Health
Speciality
-
Taxonomy
251S00000X
License No.
(North Carolina)
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
person
Provider's Taxonomy Details 2
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320600000X
License No.
(North Carolina)
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
person
Provider's Taxonomy Details 3
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Mental Illness
Speciality
-
Taxonomy
320800000X
License No.
(North Carolina)
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
person
Provider's Taxonomy Details 4
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Emotionally Disturbed Children
Speciality
-
Taxonomy
322D00000X
License No.
(North Carolina)
Definition
A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
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