Organization
AUTHENTIC LOVE ROSE LLC
Active
Other names
SHANICHA MCNEILL
Organization subpart
No
Provider details
NPI number
Authorized official
SHANICHA MCNEILL (ADMINISTRATOR)
(910) 322-4506
Entity
Organization
Contact information
Practice address
2007 RAMSEY ST, FAYETTEVILLE, NC 28301-4163
(910) 322-4506
Mailing address
505 MANN ST, FAYETTEVILLE, NC 28301-6237
(910) 322-4506
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
08/02/2024
Last updated
08/02/2024
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