| NPI | 1497204143 |
|---|---|
| Doing Business As | WAKEMED PHYSICIAN PRACTICES GROUP HOME |
| Entity Type | Organization |
| Authorized Contact | MARIA JAYOUSSI Executive Director Of Finance 919-350-6089 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 208000000X Pediatrics | |
| Enumeration Date | 2016-09-22 |
| Last Update Date | 2017-03-22 |