# DRIVEN PURPOSE RESIDENTIAL LLC

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

## Provider details

- **NPI number:** 1942459284
- **Authorized official:** MR. MARQUES ANTWAN JOHNSON B.S. BUS ADM/MGMT (CEO/PRESIDENT)
- **Authorized official phone:** (919) 802-1577

## Contact information

- **Practice address:** 520 LAURENS WAY, KNIGHTDALE, NC 27545-7633
- **Practice address phone:** (919) 266-6915
- **Mailing address:** 3210 WALNUT CREEK PKWY APT G, RALEIGH, NC 27606-3693
- **Mailing address phone:** (919) 802-1577

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | — | Yes |

## Other

- **Enumeration date:** 09/11/2008
- **Last updated:** 09/11/2008