Provider Demographics
NPI:1922360684
Name:CARILLON ASSISTED LIVING OF DURHAM
Entity Type:Organization
Organization Name:CARILLON ASSISTED LIVING OF DURHAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:KROPP
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:919-852-4000
Mailing Address - Street 1:4901 WATERS EDGE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-2464
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4713 GARRETT RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-3439
Practice Address - Country:US
Practice Address - Phone:919-401-1101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARILLON ASSISTED LIVING, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-06-08
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility