Organization
NELLIE'S ADULT CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD EDWARD BROWN SR. (ADMINISTOR)
(919) 949-6019
Entity
Organization
Contact information
Practice address
1202 ARNETTE AVE, DURHAM, NC 27707-1306
(919) 688-9703
(919) 479-9055
Mailing address
1202 ARNETTE AVE, DURHAM, NC 27707-1306
(919) 688-9703
(919) 479-9055
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
FCL032116
NC
323P00000X
Psychiatric Residential Treatment Facility
FCL032116
NC
Other
Enumeration date
03/09/2012
Last updated
03/09/2012
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