# SUNDANCE

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

## Provider details

- **NPI number:** 1760726475
- **Authorized official:** MRS. KAREN LANE PTA (TPM)
- **Authorized official phone:** (919) 658-9522

## Contact information

- **Practice address:** 228 SMITH CHAPEL ROAD, MOUNT OLIVE, NC 28365
- **Practice address phone:** (919) 658-9522
- **Mailing address:** 228 SMITH CHAPEL ROAD, MOUNT OLIVE, NC 28365
- **Mailing address phone:** (919) 658-9522

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | A1737 | NC | Yes |

## Other

- **Enumeration date:** 11/19/2012
- **Last updated:** 11/19/2012