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Organization

DIYAH'S HOME INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID HAQQ (DIRECTOR)
(910) 904-6699
Entity
Organization

Contact information

Practice address
7403 LAURINBURG RD, RAEFORD, NC 28376-7296
(901) 904-6699
(901) 904-1879
Mailing address
PO BOX 2744, FAYETTEVILLE, NC 28302-2744
(910) 904-6699
(910) 904-1879

Taxonomy

Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8301895
NC
05
8301895B
NC
Enumeration date
12/07/2007
Last updated
01/10/2008
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