Healthcare Provider Details

I. General information

NPI: 1780500710
Provider Name (Legal Business Name): CJAYS PLACE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4159 BRANDON LN
BURLINGTON NC
27217-7755
US

IV. Provider business mailing address

207 E 6TH ST
BURLINGTON NC
27215-5730
US

V. Phone/Fax

Practice location:
  • Phone: 336-456-7947
  • Fax:
Mailing address:
  • Phone: 336-456-7947
  • Fax: 336-358-6777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ABIGAIL SOWA
Title or Position: MANAGER
Credential:
Phone: 336-456-7947