# JACKSON ODONDI

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Eden Spring Living Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356484877
- **Authorized official:** MR. JACKSON ODONDI (ADMINISTRATOR)
- **Authorized official phone:** (919) 949-3585

## Contact information

- **Practice address:** 3812 BOOKER AVE, DURHAM, NC 27713-1126
- **Practice address phone:** (919) 544-0874
- **Practice address fax:** (919) 544-0874
- **Mailing address:** PO BOX 15927, DURHAM, NC 27704-0927
- **Mailing address phone:** (919) 544-0874
- **Mailing address fax:** (919) 544-5331

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | HAL-032-073 | NC | Yes |

## Other

- **Enumeration date:** 02/14/2007
- **Last updated:** 07/02/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7805238 | — | NC |