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Organization

BOYS TO GENTLEMEN

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LORRAIN W MEADOWS (OWNER)
(919) 598-5355
Entity
Organization

Contact information

Practice address
2310 S MIAMI BLVD STE 138, DURHAM, NC 27703-5799
(919) 484-1717
Mailing address
2310 S MIAMI BLVD STE 138, DURHAM, NC 27703-5799
(919) 484-1717

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8300745
NC
Enumeration date
05/03/2007
Last updated
09/27/2007
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