Organization
TARHEEL RESIDENTIAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CONNIE YVETTE OMARI LPC (CLINICAL DIRECTOR)
(704) 244-9069
Entity
Organization
Contact information
Practice address
4840 QUARRYMAN ROAD, RALEIGH, NC 27610
17042449069
Mailing address
4840 QUARRYMAN ROAD, RALEIGH, NC 27610
17042449069
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
07/29/2017
Last updated
07/29/2017
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