Organization
UNLIMITEDCARE RESIDENTIAL FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER TODD HANNON SR. (DIRECTOR)
(910) 670-0153
Entity
Organization
Contact information
Practice address
120 TANNER LOOP, RAEFORD, NC 28376-9278
(910) 670-0153
(910) 878-9964
Mailing address
120 TANNER LOOP, RAEFORD, NC 28376-5466
(910) 670-0153
(910) 878-9964
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
047-087
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603810
—
NC
Enumeration date
04/26/2007
Last updated
08/22/2020
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