Organization
MANGUM FAMILY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN W RUFFIN (ADMINISTRATOR)
(919) 220-6257
Entity
Organization
Contact information
Practice address
830 N MANGUM ST, DURHAM, NC 27701-2259
(919) 688-6923
Mailing address
1913 HAVERFORD ST, DURHAM, NC 27705-3436
(919) 220-6257
(919) 220-0407
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
FCL032017
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7801295
EDS
NC
Enumeration date
02/20/2007
Last updated
08/22/2020
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