Organization
THE DOOR OF LIFE RESIDENTIAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HARVEY CAMPBELL (CEO)
(336) 420-3195
Entity
Organization
Contact information
Practice address
227 CONSTITUTION WAY, CAMERON, NC 28326-9296
(919) 499-2419
Mailing address
1505 BRAMBER PL, CONWAY, SC 29527-3177
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL043069
NC
Other
Enumeration date
08/10/2007
Last updated
08/10/2007
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