Provider Demographics
NPI:1700062254
Name:RUTH SHEETS ADULT CARE CENTER
Entity Type:Organization
Organization Name:RUTH SHEETS ADULT CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:FRAZIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-832-7227
Mailing Address - Street 1:228 WEST EDENTON STREET
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-1790
Mailing Address - Country:US
Mailing Address - Phone:919-832-7227
Mailing Address - Fax:919-829-5780
Practice Address - Street 1:228 WEST EDENTON STREET
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-1790
Practice Address - Country:US
Practice Address - Phone:919-832-7227
Practice Address - Fax:919-829-5780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-15
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care