Organization
BROST COURT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LUELLA TATE (OWNER)
(919) 878-3866
Entity
Organization
Contact information
Practice address
4512 BROST CT, RALEIGH, NC 27616-5377
(919) 878-3866
(919) 878-3866
Mailing address
4512 BROST CT, RALEIGH, NC 27616-5377
(919) 878-3866
(919) 878-3866
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
MHL-092-585
NC
Other
Enumeration date
03/29/2007
Last updated
12/07/2012
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