Organization
TLC ADULT GROUP HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RENEE HAZELWOOD (ADMINISTRATOR)
(919) 937-3437
Entity
Organization
Contact information
Practice address
401 MOLINE ST, DURHAM, NC 27707-2347
(919) 937-3437
Mailing address
PO BOX 11998, DURHAM, NC 27703-1998
(919) 937-3437
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
MHL#032-441
NC
Other
Enumeration date
08/13/2008
Last updated
07/17/2013
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