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Organization

LITTLE FAMILY CARE HOME, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISS TONDRA ANJANETTE LITTLE (ADMINISTRATOR)
(984) 227-2543
Entity
Organization

Contact information

Practice address
1012 DAVINCI STREET, DURHAM, NC 27704
(984) 227-2543
(984) 219-6264
Mailing address
PO BOX 16014, DURHAM, NC 27704-1014
(984) 227-2543
(984) 219-6264

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
FCL-032459
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1033625702
NC
Enumeration date
12/26/2017
Last updated
12/26/2017
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