Healthcare Provider Details

I. General information

NPI: 1700062254
Provider Name (Legal Business Name): RUTH SHEETS ADULT CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2008
Last Update Date: 12/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228 WEST EDENTON STREET
RALEIGH NC
27603-1790
US

IV. Provider business mailing address

228 WEST EDENTON STREET
RALEIGH NC
27603-1790
US

V. Phone/Fax

Practice location:
  • Phone: 919-832-7227
  • Fax: 919-829-5780
Mailing address:
  • Phone: 919-832-7227
  • Fax: 919-829-5780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateNC

VIII. Authorized Official

Name: MR. MATT FRAZIER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 919-832-7227