Organization
SOUTHEASTERN WAKE ADULT DAY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EVELYN SANDERS L.C.S.W. (PRESIDENT)
(919) 231-2245
Entity
Organization
Contact information
Practice address
3401 CARL SANDBURG CT, RALEIGH, NC 27610-2049
(919) 212-8580
(919) 212-8581
Mailing address
PO BOX 46775, RALEIGH, NC 27620-6775
(919) 231-2245
(919) 231-1755
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HC 2164
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408446
—
NC
05
—
6600825
—
NC
Enumeration date
01/16/2007
Last updated
07/21/2022
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