Provider Demographics
NPI:1417226903
Name:MISS RUBY'S PLACE
Entity Type:Organization
Organization Name:MISS RUBY'S PLACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:WAKISHA
Authorized Official - Middle Name:ARNEE
Authorized Official - Last Name:HIGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-937-9892
Mailing Address - Street 1:213 KNOX CIR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-1341
Mailing Address - Country:US
Mailing Address - Phone:919-937-9892
Mailing Address - Fax:
Practice Address - Street 1:213 KNOX CIR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-1341
Practice Address - Country:US
Practice Address - Phone:919-937-9892
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-29
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL-032-112311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home