Provider Demographics
NPI:1497014393
Name:KIDDLE PREP SCHOOL, INC
Entity Type:Organization
Organization Name:KIDDLE PREP SCHOOL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARICOMA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-491-4766
Mailing Address - Street 1:PO BOX 11343
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-4354
Mailing Address - Country:US
Mailing Address - Phone:919-251-9692
Mailing Address - Fax:919-957-4681
Practice Address - Street 1:2727 MARLIN DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-4350
Practice Address - Country:US
Practice Address - Phone:919-251-9692
Practice Address - Fax:919-957-4681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-11
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility