Organization
BROTHERS CARE GROUP HOMES LLC
Active
Other names
Brothers Care Group Homes LLC
Organization subpart
No
Provider details
NPI number
Authorized official
KEL DELPHINE NJIKE TAH (MANAGER)
(617) 877-1429
Entity
Organization
Contact information
Practice address
611 BEAUHAVEN LN, WAXHAW, NC 28173-7451
(617) 877-1429
Mailing address
611 BEAUHAVEN LN, WAXHAW, NC 28173-7451
(617) 877-1429
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
323P00000X
Psychiatric Residential Treatment Facility
—
—
Other
Enumeration date
06/01/2024
Last updated
06/04/2024
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