Organization
A PRIMARY CHOICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THAD JUNIOR DAVIS (DIRECTOR)
(910) 739-1445
Entity
Organization
Contact information
Practice address
22421 ANDREW JACKSON HWY, MAXTON, NC 28364-6721
(910) 844-2008
(910) 844-4002
Mailing address
500 PETERSON DR, LUMBERTON, NC 28358-2600
(910) 739-1445
(910) 739-1447
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
02/23/2007
Last updated
08/22/2020
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