Organization
DAVIS FAMILY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATANYA DAVIS MAED (EXECUTIVE DIRECTOR)
(252) 409-0080
Entity
Organization
Contact information
Practice address
6604 E US 264 ALT, WILSON, NC 27893
(252) 409-0080
(252) 409-0095
Mailing address
3410 QUEENSFERRY DR NW, WILSON, NC 27896-1492
(252) 258-6666
(252) 237-5834
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL-098-166
NC
Other
Enumeration date
11/04/2011
Last updated
11/04/2011
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