Organization
ATHENS PLACE
Active
Parent organization
PHP OF NC, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHP OF NC, INC
Authorized official
MRS. JUSTINE WIGGINS (CEO)
(919) 220-0021
Entity
Organization
Contact information
Practice address
1500 E CLUB BLVD, DURHAM, NC 27704-3404
(919) 220-0021
(919) 220-4555
Mailing address
1921 ATHENS AVE, DURHAM, NC 27707-4315
(919) 220-0021
(919) 220-4555
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL032597
NC
Other
Enumeration date
02/20/2015
Last updated
02/20/2015
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