Provider Demographics
NPI:1215194048
Name:BLEVINS TOO INC
Entity Type:Organization
Organization Name:BLEVINS TOO INC
Other - Org Name:BLEVINS TOO
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAYNE
Authorized Official - Middle Name:E
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-956-7901
Mailing Address - Street 1:PO BOX 25265
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27702-5265
Mailing Address - Country:US
Mailing Address - Phone:919-596-7901
Mailing Address - Fax:919-682-3873
Practice Address - Street 1:2325 COOK RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-2734
Practice Address - Country:US
Practice Address - Phone:919-956-9701
Practice Address - Fax:919-682-3873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL032083311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home