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Organization
OUTREACH HOME #1
Active
Organization
OUTREACH HOME #1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOY N. OKEKE RN (ADMINISTRATOR)
(919) 641-0162
Entity
Organization
Contact information
Practice address
2826 S ROXBORO ST, DURHAM, NC 27707-4039
(919) 401-8352
Mailing address
305 SHALIMAR DR, DURHAM, NC 27713-7571
(919) 544-1033
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
MHL032299
NC
Other
Enumeration date
04/17/2007
Last updated
08/22/2020
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