Organization
DIYAH'S HOME, INC
Active
Other names
diyah's home #2
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID HAQQ (DIRECTOR/OWNER)
(910) 978-8599
Entity
Organization
Contact information
Practice address
10691 NC HIGHWAY 210 S, SPRING LAKE, NC 28390-8049
(910) 497-8599
(910) 436-5928
Mailing address
PO BOX 2744, FAYETTEVILLE, NC 28302-2744
(910) 497-8599
(910) 436-5928
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-043-056
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603854
—
NC
Enumeration date
09/26/2006
Last updated
08/11/2008
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