Organization
THE M & L HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LETICIA LIDE (INCORPORATOR)
(910) 703-9111
Entity
Organization
Contact information
Practice address
3901 DAYTONA RD, FAYETTEVILLE, NC 28311-2117
(910) 703-9111
Mailing address
3901 DAYTONA RD, FAYETTEVILLE, NC 28311-2117
(910) 703-9111
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
—
—
Other
Enumeration date
06/15/2026
Last updated
06/15/2026
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