Organization
PENDER ADULT SERVICE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WESLEY B DAVIS (EXECUTIVE DIRECTOR)
(910) 259-9119
Entity
Organization
Contact information
Practice address
901 S WALKER ST, BURGAW, NC 28425-5009
(910) 259-9119
(910) 259-9144
Mailing address
PO BOX 1251, BURGAW, NC 28425-1251
(910) 259-9119
(910) 259-9144
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
3408224
NC
251E00000X
Home Health Agency
3408224
NC
251E00000X
Home Health Agency
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408224
—
NC
05
—
6600114
—
NC
Enumeration date
01/17/2007
Last updated
07/21/2022
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