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General NPI Number Information
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NPI Number | 1649539362
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Entity Type | Organization
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Legal Business Name | NEXUS DEVELOPMENTAL CENTER
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Dates
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Enumeration Date | 05/15/2012
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Last Update Date | 05/31/2012
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Provider Practice Location Address
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Address Line | 103 E. RAILROAD STREET
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City | ROBERSONVILLE
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State | NC
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Zip | 27871
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Country | US
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Telephone | 252-795-5886
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Fax | 252-795-5886
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Provider Business Mailing Address
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Address Line | PO BOX 451
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City | ROBERSONVILLE
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State | NC
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Zip | 27871-0451
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Country | US
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Telephone | 252-795-5886
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Fax | 252-795-5886
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | TOMIKA LOSHAWN BRYANT
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Credential |
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Telephone | 252-217-8780
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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