Organization
UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL
Active
Other names
CLLC (Carolina Living & Learning Center)
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD L. MANN (VICE CHANCELLOR FINANCE & ADMIN)
(919) 962-3798
Entity
Organization
Contact information
Practice address
325 RUSSET RUN, PITTSBORO, NC 27312-5000
(919) 542-1910
(919) 542-0978
Mailing address
325 RUSSET RUN, PITTSBORO, NC 27312-5000
(919) 542-1910
(919) 542-0978
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL019007
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27G.2300
SERVICE CODE-ADVP ICF/MR
NC
01
—
27G.5600C
SRVCS-SPVLIVDDADLT ICF-MR
NC
05
—
3406187
—
NC
05
—
921564
—
NC
01
—
GM4
DSS FACILITY CODE
NC
01
—
MHL-019-007
LICENSE NUMBER
NC
Enumeration date
10/10/2006
Last updated
03/18/2008
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