Provider Demographics
NPI:1851415012
Name:JOFLO SPECIALTY CARE
Entity Type:Organization
Organization Name:JOFLO SPECIALTY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:BOTCHWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-768-8405
Mailing Address - Street 1:2303 NC HIGHWAY 55
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-4901
Mailing Address - Country:US
Mailing Address - Phone:919-768-8405
Mailing Address - Fax:
Practice Address - Street 1:2303 NC HIGHWAY 55
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-4901
Practice Address - Country:US
Practice Address - Phone:919-768-8405
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness