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Organization

AVALON # 4

Active
Organization subpart
No

Provider details

NPI number
Authorized official
IJEOMA NWANKWO (OWNER)
(336) 253-2219
Entity
Organization

Contact information

Practice address
5040 KAPLAN DR, RALEIGH, NC 27606-2523
(336) 253-2219
Mailing address
4428 LOUISBURG RD, SUITE 109, RALEIGH, NC 27616-4302
(336) 253-2219

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary

Other

Enumeration date
12/01/2009
Last updated
12/01/2009
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