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34D2271271 CLIA NUMBER - EDUCARE COMMUNITY LIVING CORPORATION OF NC- BLANCHE

Laboratory Demographics

CLIA Number: 34D2271271

Facility Name: EDUCARE COMMUNITY LIVING CORPORATION OF NC- BLANCHE

Facility Address:
6208 BALANCHE DRIVE
RALEIGH, NC
ZIP 27607
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Facility Phone Number: 919 827-2790

Facility Type: Intermediate Care Facility for Mentally Retarded

Certificate Type: Waiver
NPI Number: 1215057856

Taxonomy: 315P00000X - Intermediate Care Facility, Intellectual Disabilities
An intermediate care facility providing services for individuals with intellectual disabilities.

CLIA Record

Field Name Field Value
CLIA Number 34D2271271
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name EDUCARE COMMUNITY LIVING CORPORATION OF NC- BLANCHE
Street 6208 BALANCHE DRIVE
City RALEIGH
State NC
ZIP 27607
Phone 919 827-2790
CertificateType 4
CertificateEffectiveDate 10/31/2022
CertificateExpirationDate 10/30/2024
FacilityType Waiver

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This page was last updated on: 4/23/2024