Organization
BIG BROTHER,LLC
Active
Other names
Big Brother @ Lancaster
Organization subpart
No
Provider details
NPI number
Authorized official
BEN JOHNSON SR. (COO)
(919) 667-5700
Entity
Organization
Contact information
Practice address
1102 LANCASTER ST, DURHAM, NC 27701-1148
(919) 667-5700
Mailing address
1102 LANCASTER ST, DURHAM, NC 27701-1148
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
NC
Other
Enumeration date
01/28/2010
Last updated
01/28/2010
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