Organization
DIYAH'S HOME INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID OMAR HAQQ MA (DIRECTOR)
(910) 978-8599
Entity
Organization
Contact information
Practice address
295 APPALOOSA DR, SPRING LAKE, NC 28390-8503
(910) 497-8599
(910) 436-5928
Mailing address
295 APPALOOSA DR, SPRING LAKE, NC 28390-8503
(910) 497-8599
(910) 436-5928
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
MHL-026-583
NC
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
MHL-043-045
NC
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL-043-056
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603270
—
NC
05
—
6603538
—
NC
05
—
6603854
—
NC
Enumeration date
07/13/2006
Last updated
08/22/2020
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