Provider Demographics
NPI:1346065000
Name:JUNIPER HOME L.L.C
Entity type:Organization
Organization Name:JUNIPER HOME L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAMLA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDULLAHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-349-0789
Mailing Address - Street 1:8816 AUBURN WHISPER LN
Mailing Address - Street 2:
Mailing Address - City:MINT HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28227-4398
Mailing Address - Country:US
Mailing Address - Phone:980-349-0789
Mailing Address - Fax:
Practice Address - Street 1:2941 CORONET WAY
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-3213
Practice Address - Country:US
Practice Address - Phone:980-349-0789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities