Organization
JOEL'S PLACE ADULT HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALEAN MCQUEEN LOVE REGISTERED NURSE (DIRECTOR OF OPERATIONS)
(910) 978-6083
Entity
Organization
Contact information
Practice address
6739 SHAD CT, STEDMAN, NC 28391-9448
(910) 484-6005
(910) 401-1010
Mailing address
1508 DOVETAIL DR, FAYETTEVILLE, NC 28314-6216
(910) 978-6083
(910) 401-1010
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
7805609
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7805609
—
NC
Enumeration date
12/31/2007
Last updated
12/31/2007
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