Provider Demographics
NPI:1194458042
Name:UNIQUE ASSISTED LIVING
Entity type:Organization
Organization Name:UNIQUE ASSISTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:IKECHI
Authorized Official - Last Name:AMADI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-433-7662
Mailing Address - Street 1:6320 SAYBROOKE DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-1282
Mailing Address - Country:US
Mailing Address - Phone:919-433-7662
Mailing Address - Fax:
Practice Address - Street 1:6320 SAYBROOKE DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-1282
Practice Address - Country:US
Practice Address - Phone:919-433-7662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-07
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1992436976Medicaid