Organization
DANIEL'S DEN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRUCE DANIEL (ADMINISTRATOR)
(919) 523-4942
Entity
Organization
Contact information
Practice address
1919 BOAZ RD, RALEIGH, NC 27610-4005
(919) 836-0158
(919) 836-0158
Mailing address
1919 BOAZ RD, RALEIGH, NC 27610-4005
(919) 836-0158
(919) 836-0158
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
MHL-092-851
NC
Other
Enumeration date
10/02/2012
Last updated
10/02/2012
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