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Organization
SOUTHEASTERN WAKE ADULT DAY CENTER
Active
Organization
SOUTHEASTERN WAKE ADULT DAY CENTER
Active
Other names
Southeastern Adult Day Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EVELYN LANE SANDERS LCSW (EXECUTIVE DIRECTOR)
(919) 212-8580
Entity
Organization
Contact information
Practice address
3401 CARL SANDBURG CT, RALEIGH, NC 27610-2049
(919) 212-8580
(919) 212-8581
Mailing address
PO BOX 46775, RALEIGH, NC 27620-6775
(919) 212-8580
(919) 212-8581
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
HC2164
NC
251E00000X
Home Health Agency
Primary
HC2279
NC
251E00000X
Home Health Agency
HC2402
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408446
—
NC
05
—
6006326
—
NC
05
—
6600825
—
NC
Enumeration date
01/22/2016
Last updated
01/22/2016
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