Organization
CHESTNUT MANOR MANGUM STREET
Active
Parent organization
CHESTNUT MANOR INC.
Other names
chestnut manor
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHESTNUT MANOR INC.
Authorized official
MRS. YOLANDA CHESTNUT JACKSON (ADMINISTRATOR)
(919) 638-6174
Entity
Organization
Contact information
Practice address
830 N MANGUM ST, DURHAM, NC 27701-2259
(919) 688-6923
Mailing address
830 N MANGUM ST, DURHAM, NC 27701-2259
(919) 688-6923
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
FCL-032-092
NC
Other
Enumeration date
02/05/2009
Last updated
02/05/2009
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