NPI 1407931611

Community Innovations INC 63

Organisation Intellectual Disabilities Intermediate Care Facility Holly Springs, NC

Practice location

Address: 904 Avent Ferry Rd, Holly Springs, NC 27540-8416
Phone: (919) 577-6749
Mailing address: 3210 Fairhill Dr, Raleigh, NC 27612-3220

Authorised official

Name: Andy Anderson
Title: President
Phone: (910) 642-5697

Registered specialties

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X Licence MHL092126 (NC)

Other Intermediate Care Facility, Intellectual Disabilities providers in North Carolina →

Registry record

NPI: 1407931611
Entity type: Organization
NPI issued: 26 Oct 2006
Record last updated: 22 Aug 2020

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.