# AZALEA GARDEN

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194150417
- **Authorized official:** YALONDA COLEMAN (ADMINISTRATIVE)
- **Authorized official phone:** (919) 208-8635

## Contact information

- **Practice address:** 413 CULVERT ST, APEX, NC 27502-1731
- **Practice address phone:** (919) 523-5767
- **Mailing address:** 413 CULVERT ST, APEX, NC 27502-1731
- **Mailing address phone:** (919) 523-5767

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | MHL092659 | NC | Yes |
| 320700000X | Physical Disabilities Residential Treatment Facility | MHL092659 | NC | — |

## Other

- **Enumeration date:** 09/05/2013
- **Last updated:** 09/05/2013