Organization · Type 2 NPI

Lisa Pettiford

Adult Care Home Facility · Durham, NC

NPI number 1790979193 Active

Practice location

502 Hugo Street
Durham, NC 27704-0335

Call (919) 599-3691 Map

Fax (919) 493-2112

Mailing address

PO Box 15335
Durham, NC 27704-0335

Specialties and licenses

TaxonomyCodeLicense
Adult Care Home Facility Primary 311ZA0620X032-406 (NC)

Adult Care Home Facility: A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.

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About NPI 1790979193

Lisa Pettiford's National Provider Identifier is 1790979193, issued on Aug 29, 2007. The primary taxonomy on file is Adult Care Home Facility (311ZA0620X), and the practice location is in Durham, NC. The record was last updated on Jul 10, 2008.