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Organization

WALK BY FAITH ADULT HEALTH & DAY CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEANGELO JACKSON (OWNER/HEALTH CARE COORDINATOR)
(910) 891-2770
Entity
Organization

Contact information

Practice address
1004 W BROAD ST, DUNN, NC 28334-4708
(910) 891-2770
(910) 891-2771
Mailing address
1004 W BROAD ST, DUNN, NC 28334-4708
(910) 891-2770
(910) 891-2771

Taxonomy

Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
PE KX5D1Z7TA
NC
305S00000X
Point of Service
PE-KX5D1Z7TA
NC
311Z00000X
Custodial Care Facility
PE-KX5D1Z7TA
NC
385H00000X
Respite Care
Primary
PE-KX5D1Z7TA
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40312372
NC
Enumeration date
06/27/2014
Last updated
02/12/2015
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