BEAUFORT COUNTY GROUP HOME #1
NPI 1235269267
Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Washington, NC
- Organization
- Residential Treatment Facility, Intellec...
- CLIA Number: 34D2136814
- CLIA Cert. Type: Prison
- CLIA Exp. Date: 09-14-2027
About BEAUFORT COUNTY GROUP HOME #1
This page provides the complete NPI Profile along with additional information for Beaufort County Group Home #1, a provider established in Washington, North Carolina operating as a Residential Treatment Facility, Intellectual And/or Developmental Disabilities. The healthcare provider is registered in the NPI registry with number 1235269267 assigned on March 2007. The practitioner's primary taxonomy code is 320600000X with license number MHL007026 (NC). The provider is registered as an organization and their NPI record was last updated 9 years ago. The provider's is doing business as Beaufort County Group Home #1. The authorized official of this NPI record is Mrs. Elena Gilmore Cameron (Coo)
- NPI
- 1235269267 Verify this NPI
- Provider Legal Name
- BEAUFORT COUNTY DEVELOPMENTAL CENTER, INC
- Other Organization Name
- BEAUFORT COUNTY GROUP HOME #1
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1534 W 5TH ST WASHINGTON, NC 27889
- Location Phone
- (252) 946-0151
- Location Fax
- (252) 946-9783
- Mailing Address
- P.O. BOX 518 1534 WEST 5TH STREET WASHINGTON, NC 27889
- Mailing Phone
- (252) 946-0151
- Mailing Fax
- (252) 946-9783
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-07-2007
- Last Update Date
- 02-17-2017
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Taxonomy Code
- 320600000X
- Type
- Residential Treatment Facilities
- License No.
- MHL007026
- License State
- NC
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 311ZA0620X | Nursing & Custodial Care Facilities | Custodial Care Facility | MHL007026 (NC) |
| 2 | 320900000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | MHL007026 (NC) |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 34D2136814
- Facility Type
- Prison
- Certificate Effective Date
- September 15, 2025
- Certificate Expiration Date
- September 14, 2027
- Laboratory Director
- KELLEY M. NEWMAN
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Beaufort County Group Home #1 in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
Reviews for BEAUFORT COUNTY GROUP HOME #1
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Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
WASHINGTON, NC 27889
WASHINGTON, NC 27889
WASHINGTON, NC 27889
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1235269267, enumerated as an "organization" on March 07, 2007.
The provider is located at 1534 W 5TH ST WASHINGTON, NC 27889 and the phone number is (252) 946-0151.
Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320600000X.
