Organization
THE PICKETT HOUSE FAMILY CARE HOME
Active
Other names
TCHS Day Activity Program
Organization subpart
No
Provider details
NPI number
Authorized official
CORNELL JONES (ADMINISTRATOR)
(919) 403-9644
Entity
Organization
Contact information
Practice address
1913 LAMAR ST, DURHAM, NC 27705-3310
(919) 403-9644
(919) 489-8489
Mailing address
3811 PICKETT RD, DURHAM, NC 27705-5331
(919) 403-9644
(919) 489-8489
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
MHL-032-376
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408619
—
NC
Enumeration date
01/09/2007
Last updated
07/21/2008
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