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Organization

TILLERY'S PLACE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISS SHAVONNIE DEANS (OWNER)
(252) 446-6613
Entity
Organization

Contact information

Practice address
200 S TILLERY ST, ROCKY MOUNT, NC 27804-5527
(252) 446-6613
Mailing address
200 S TILLERY ST, ROCKY MOUNT, NC 27804-5527

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
FCL-064-030
NC

Other

Enumeration date
08/18/2015
Last updated
08/18/2015
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