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Organization
UNLOCKING POTENTIAL RESIDENTIAL GROUP HOME LLC
Active
Organization
UNLOCKING POTENTIAL RESIDENTIAL GROUP HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOMINIQUE DEMONTRELL ROBINSON (CEO)
(910) 551-1806
Entity
Organization
Contact information
Practice address
5025 WINDFLOWER DR, FAYETTEVILLE, NC 28314-0749
(910) 551-1806
Mailing address
6809 WOODMARK DR, FAYETTEVILLE, NC 28314-6458
(910) 551-1806
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/27/2024
Last updated
06/30/2024
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