Organization
NELA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL MOORE JR. (PRESIDENT/HUMAN RESOURCES MANAGER)
(252) 375-5110
Entity
Organization
Contact information
Practice address
3011 MEMORIAL BLVD, SUITE 8, GREENVILLE, NC 27834-6238
(252) 375-5110
(252) 215-1558
Mailing address
3011 S MEMORIAL DR, SUITE 8, GREENVILLE, NC 27834-6238
(252) 375-5110
(252) 215-1558
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
Other
Enumeration date
06/30/2011
Last updated
06/30/2011
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