# TARHEEL RESIDENTIAL SERVICES

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

## Provider details

- **NPI number:** 1891219093
- **Authorized official:** DR. CONNIE YVETTE OMARI LPC (CLINICAL DIRECTOR)
- **Authorized official phone:** (704) 244-9069

## Contact information

- **Practice address:** 4840 QUARRYMAN ROAD, RALEIGH, NC 27610
- **Practice address phone:** 17042449069
- **Mailing address:** 4840 QUARRYMAN ROAD, RALEIGH, NC 27610
- **Mailing address phone:** 17042449069

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |
| 320900000X | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | — | NULL | — |

## Other

- **Enumeration date:** 07/29/2017
- **Last updated:** 07/29/2017