Organization
DYNASTY DIVERSE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. THOMINA MCNAIR-MILLS (MANAGING MEMBER)
(336) 462-7275
Entity
Organization
Contact information
Practice address
211 JULIAN POND LN, KERNERSVILLE, NC 27284-2461
(336) 462-7275
Mailing address
211 JULIAN POND LN, KERNERSVILLE, NC 27284-2461
(336) 462-7275
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/10/2009
Last updated
03/29/2011
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