Provider Demographics
NPI:1477675957
Name:ROYSTERS FAMILY CARE
Entity Type:Organization
Organization Name:ROYSTERS FAMILY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-767-8332
Mailing Address - Street 1:2310 HOLLOWAY ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-3316
Mailing Address - Country:US
Mailing Address - Phone:919-767-8332
Mailing Address - Fax:919-767-8332
Practice Address - Street 1:2310 HOLLOWAY ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-3316
Practice Address - Country:US
Practice Address - Phone:919-767-8332
Practice Address - Fax:919-767-8332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility