# KIMBERLY HOME

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427214956
- **Authorized official:** CHARLMAYNE SEABERRY ALSTON (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (919) 798-8638

## Contact information

- **Practice address:** 6701 LITCHFORD RD, RALEIGH, NC 27615-7112
- **Practice address phone:** (919) 798-8638
- **Practice address fax:** (919) 872-5412
- **Mailing address:** 1733 HODGE RD, KNIGHTDALE, NC 27545-9588
- **Mailing address phone:** (919) 872-5412
- **Mailing address fax:** (919) 872-5412

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | MHL092633 | NC | Yes |

## Other

- **Enumeration date:** 08/04/2008
- **Last updated:** 08/04/2008