Organization
EASON COURT
Active
Other names
Eason Court
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DAPHINE LLOYD CARROLL (EXECUTIVE DIRECTOR)
(919) 556-4720
Entity
Organization
Contact information
Practice address
113 EASON CT, YOUNGSVILLE, NC 27596-9228
(919) 556-4720
(919) 556-3003
Mailing address
113 EASON CT, YOUNGSVILLE, NC 27596-9228
(919) 556-4720
(919) 556-3003
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL-035-029
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7804575
—
NC
Enumeration date
03/28/2007
Last updated
08/22/2020
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