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Organization
TILLERY'S PLACE, LLC
Active
Organization
TILLERY'S PLACE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS SHAVONNIE DEANS (OWNER)
(252) 446-6613
Entity
Organization
Contact information
Practice address
200 S TILLERY ST, ROCKY MOUNT, NC 27804-5527
(252) 446-6613
Mailing address
200 S TILLERY ST, ROCKY MOUNT, NC 27804-5527
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
FCL-064-030
NC
Other
Enumeration date
08/18/2015
Last updated
08/18/2015
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