Organization
PEACEFUL HOUSE III
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLEY Y JEGBADAI RN (ADMINISTRATOR)
(919) 790-1953
Entity
Organization
Contact information
Practice address
2724 MARLIN DR, DURHAM, NC 27703-4354
(919) 641-7981
(919) 957-4681
Mailing address
2724 MARLIN DR, DURHAM, NC 27703-4354
(919) 641-7981
(919) 957-4681
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7805386
—
NC
Enumeration date
06/20/2007
Last updated
08/22/2020
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