OrganizationActive
Bo'S Johnathan House, Inc.
NPI 1194970681 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Middlesex, NC
Provider details
- NPI number
- 1194970681
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Parent organization
- Bo'S Johnathan House, Inc.
- Organization subpart
- Yes
- Authorized official
- Obelia Hocutt, Executive Director(919) 369-5394
- License
- MHL-051-168 (NC)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000XLicense MHL-051-168 (NC)
Residential Treatment Facilities
- Intellectual and/or Developmental Disabilities Residential Treatment Facility320600000XLicense MHL-051-168 (NC)
Residential Treatment Facilities
Practice location
300 Will Rd
Middlesex, NC 27557-8317
Phone: (919) 369-5394
Approximate (ZIP-level) locationGet directions
Mailing address
12749 Buck Rd
Middlesex, NC 27557-8308
Other names (DBA / former)
- Doing business as
- Bo'S Johnathan House Adult Care, Inc.
Registry dates
- Enumerated
- 2008-11-25
- Last updated
- 2009-01-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.