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Organization
AVALON # 3
Active
Organization
AVALON # 3
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IJEOMA NWANKWO (OWNER)
(336) 253-2219
Entity
Organization
Contact information
Practice address
4133 WHITE PINE DR, RALEIGH, NC 27612-3737
(336) 253-2219
Mailing address
4428 LOUISBURG RD, SUITE 109, RALEIGH, NC 27616-4302
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
NULL
Other
Enumeration date
03/03/2010
Last updated
03/03/2010
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