Organization
BROTHERS CARE GROUP HOMES LLC
Active
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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