Provider Demographics
NPI:1992148209
Name:TOWER OF BLESSING A REFUGE TO SEEK
Entity type:Organization
Organization Name:TOWER OF BLESSING A REFUGE TO SEEK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FORBES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-680-6360
Mailing Address - Street 1:2309 ELLINGTON ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-5213
Mailing Address - Country:US
Mailing Address - Phone:919-680-6360
Mailing Address - Fax:919-596-7391
Practice Address - Street 1:2309 ELLINGTON ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-5213
Practice Address - Country:US
Practice Address - Phone:919-680-6360
Practice Address - Fax:919-596-7391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-17
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC032129261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service