Organization
NIXON HOUSE
Active
Parent organization
PHP OF NC, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHP OF NC, INC
Authorized official
MRS. JUSTINE WIGGINS (CEO)
(919) 220-0021
Entity
Organization
Contact information
Practice address
1500 E CLUB BLVD, DURHAM, NC 27704-3404
(919) 220-0021
(919) 220-0021
Mailing address
1525 NIXON ST, DURHAM, NC 27707-4353
(919) 220-0021
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL 032245
NC
Other
Enumeration date
08/06/2013
Last updated
08/06/2013
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