Uniquely Supported

NPI 1689710162 - Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities - 320600000X

NPI Details
NPI 1689710162
Enumeration Date 01/30/2007
Last Updated 07/09/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name DANA DANA
Position ADMINSTRATOR
Phone (704) 538-3648
Fax
Practice Location
2904 PHILADELPHIA RD
LAWNDALE NC, 28090-9461, US
Phone (704) 538-3648
Fax
Business Location
PO BOX 690
FALLSTON NC, 28042-0690, US
Phone (704) 538-3648
Fax (704) 538-6940
Toxanomy
Taxonomy Code 320600000X
License State
License Number
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According to our database, Uniquely Supported NPI is 1689710162, taxonomy code is 320600000X Uniquely Supported physically located at 2904 Philadelphia Rd, Lawndale NC, 28090-9461. NPI Number 1033115704 has the healthcare provider type.

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1689710162 NPI number is provided on an as is basis without warranty of any kind. 1689710162 is maintained by the National Plan & Provider Enumeration System. The contents of Uniquely Supported are for informational purposes only.