# AVALON \# 3

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

## Provider details

- **NPI number:** 1457674574
- **Authorized official:** IJEOMA NWANKWO (OWNER)
- **Authorized official phone:** (336) 253-2219

## Contact information

- **Practice address:** 4133 WHITE PINE DR, RALEIGH, NC 27612-3737
- **Practice address phone:** (336) 253-2219
- **Mailing address:** 4428 LOUISBURG RD, SUITE 109, RALEIGH, NC 27616-4302

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 03/03/2010
- **Last updated:** 03/03/2010