# DANIEL'S DEN, LLC

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

## Provider details

- **NPI number:** 1295087161
- **Authorized official:** MR. BRUCE DANIEL (ADMINISTRATOR)
- **Authorized official phone:** (919) 523-4942

## Contact information

- **Practice address:** 1919 BOAZ RD, RALEIGH, NC 27610-4005
- **Practice address phone:** (919) 836-0158
- **Practice address fax:** (919) 836-0158
- **Mailing address:** 1919 BOAZ RD, RALEIGH, NC 27610-4005
- **Mailing address phone:** (919) 836-0158
- **Mailing address fax:** (919) 836-0158

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | MHL-092-851 | NC | Yes |

## Other

- **Enumeration date:** 10/02/2012
- **Last updated:** 10/02/2012