Organization
AVALON FARM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS KIMBERLY ANN CLARKE (EXECUTIVE DIRECTOR)
(704) 585-6377
Entity
Organization
Contact information
Practice address
166 FAIR OAKS LN, STONY POINT, NC 28678-9209
(704) 585-6377
Mailing address
166 FAIR OAKS LN, STONY POINT, NC 28678-9209
(704) 585-6377
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
08/18/2009
Last updated
09/29/2009
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