Organization
SUPREME RESIDENTIAL CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN CHAMBERS (OWNER)
(919) 482-8299
Entity
Organization
Contact information
Practice address
315 ROCHE DR, DURHAM, NC 27703
(919) 482-8299
Mailing address
315 ROCHE DR, DURHAM, NC 27703
(919) 482-8299
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
Other
Enumeration date
08/18/2023
Last updated
08/18/2023
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