Provider Demographics
NPI:1649539362
Name:NEXUS DEVELOPMENTAL CENTER
Entity type:Organization
Organization Name:NEXUS DEVELOPMENTAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TOMIKA
Authorized Official - Middle Name:LOSHAWN
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-217-8780
Mailing Address - Street 1:PO BOX 451
Mailing Address - Street 2:
Mailing Address - City:ROBERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27871-0451
Mailing Address - Country:US
Mailing Address - Phone:252-795-5886
Mailing Address - Fax:252-795-5886
Practice Address - Street 1:103 E. RAILROAD STREET
Practice Address - Street 2:
Practice Address - City:ROBERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:27871
Practice Address - Country:US
Practice Address - Phone:252-795-5886
Practice Address - Fax:252-795-5886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-15
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251E00000XAgenciesHome Health