# JUA VALLEY FAMILY CARE HOME \#2

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** JUA VALLEY FAMILY CARE HOME
- **Other names:** JUA VALLEY FAMILY CARE HOME
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1225382070
- **Legal business name:** JUA VALLEY FAMILY CARE HOME
- **Authorized official:** MRS. KANISHA DICKENS LPN (FAMILY CARE ADMINISTRATOR)
- **Authorized official phone:** (866) 654-1113

## Contact information

- **Practice address:** 2 JUA VLY, DURHAM, NC 27707-1507
- **Practice address phone:** (866) 654-1113
- **Practice address fax:** (919) 439-0222
- **Mailing address:** 2 JUA VLY, DURHAM, NC 27707-1507
- **Mailing address phone:** (866) 654-1113
- **Mailing address fax:** (919) 439-0222

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | FCL-032-122 | NC | Yes |

## Other

- **Enumeration date:** 11/01/2012
- **Last updated:** 11/01/2012