Organization
THE DURHAM FAMILY GROUP HOME 'LODGE STREET HOUSE'
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN COX DURHAM LPN (OWNER)
(919) 730-7405
Entity
Organization
Contact information
Practice address
203 LODGE ST, DURHAM, NC 27707-2339
(919) 682-5375
(919) 682-5375
Mailing address
203 LODGE ST, DURHAM, NC 27707-2339
(919) 682-5375
(919) 682-5375
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
MHL032393
NC
Other
Enumeration date
02/19/2007
Last updated
08/28/2007
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