NPI 1003197609

Residential Services at Revere, LLC

Organisation Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Hillsborough, NC

Practice location

Address: 516a Revere Rd, Hillsborough, NC 27278
Phone: (919) 241-4474
Mailing address: 4511 Nc Highway 86 N, Hillsborough, NC 27278-9250

Authorised official

Name: Jackie J Parker
Title: Director
Phone: (919) 452-8903

Registered specialties

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X Licence 068151 (NC)

Other Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in North Carolina →

Registry record

NPI: 1003197609
Entity type: Organization
NPI issued: 9 Sep 2011
Record last updated: 9 Sep 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.