# THE DOOR OF LIFE RESIDENTIAL SERVICES

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

## Provider details

- **NPI number:** 1285826503
- **Authorized official:** HARVEY CAMPBELL (CEO)
- **Authorized official phone:** (336) 420-3195

## Contact information

- **Practice address:** 227 CONSTITUTION WAY, CAMERON, NC 28326-9296
- **Practice address phone:** (919) 499-2419
- **Mailing address:** 1505 BRAMBER PL, CONWAY, SC 29527-3177

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | MHL043069 | NC | Yes |

## Other

- **Enumeration date:** 08/10/2007
- **Last updated:** 08/10/2007