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General NPI Number Information
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NPI Number | 1144437658
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Entity Type | Organization
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Legal Business Name | ROBERT JONES
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6 HAWAII CT
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City | DURHAM
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State | NC
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Zip | 27713-1137
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Country | US
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Telephone | 919-956-8197
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Fax |
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Provider Business Mailing Address
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Address Line | 203 N MAIN ST SUITE 315
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City | ROXBORO
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State | NC
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Zip | 27573-5343
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Country | US
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Telephone | 919-956-8197
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. ROBERT JONES
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Credential |
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Telephone | 919-956-8197
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | FCL-032-047
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License Number State | NC
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