Organization
CARE OF DIVERSITY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SENETRA REYNOLDS (MEMBER/ADMINISTRATOR)
(336) 627-3336
Entity
Organization
Contact information
Practice address
1235 NORMAN DR, APT 1B, EDEN, NC 27288-5978
(336) 627-3336
Mailing address
104 BOULEVARD, EDEN, NC 27288-5220
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
FCL-079-101
NC
Other
Enumeration date
01/06/2016
Last updated
01/06/2016
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