Organization
NOVELLA'S PLACE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JESSE JAMES BANKS JR. (FINANCIAL ADMINISTRATION)
(919) 427-1402
Entity
Organization
Contact information
Practice address
2128 OLD MILBURNIE RD, RALEIGH, NC 27604-9642
(919) 266-0146
(919) 266-0146
Mailing address
1307 E MILLBROOK RD, SUITE C-15, RALEIGH, NC 27609-5476
(919) 427-1402
(919) 828-1624
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
MHL-032-418
NC
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL-032-418
NC
Other
Enumeration date
12/17/2007
Last updated
01/12/2008
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