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1518214022
CARL DIEDRITCH SICKEROTT
RALEIGH, NC
NPI
1518214022
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
311ZA0620X Custodial Care Facility, Adult Care Home
(Licence: NC MHL-092-469)
Enumeration Date
2012-08-14
Last Update Date
2012-08-24
Business Address
Mr. CARL DIEDRITCH SICKEROTT
2026 FAIRVIEW RD
RALEIGH, NC 27608-2316
Phone number: 919-946-1758
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Mailing Address
Mr. CARL DIEDRITCH SICKEROTT
2026 FAIRVIEW RD
RALEIGH, NC 27608-2316
Phone number: 919-946-1758
Copy
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