Provider Demographics
NPI:1053571299
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:
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:336-504-1461
Mailing Address - Fax:336-599-8186
Practice Address - Street 1:56 MAGGIE LN
Practice Address - Street 2:
Practice Address - City:ROXBORO
Practice Address - State:NC
Practice Address - Zip Code:27573-4189
Practice Address - Country:US
Practice Address - Phone:336-599-9171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-11
Last Update Date:2023-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X, 320800000X
NCMHL-073-047311ZA0620X, 320900000X
NCMHL-073-061320900000X
NCMHL-073-041320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No251S00000XAgenciesCommunity/Behavioral Health
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities