Individual
DONTE LEVON COLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
305 KENBROOK LN NW APT 101, CONCORD, NC 28027-0122
(609) 203-3170
Mailing address
305 KENBROOK LN NW APT 101, CONCORD, NC 28027-0122
(609) 203-3170
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
93-1644495
NC
Other
Enumeration date
06/26/2023
Last updated
06/26/2023
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