Individual
MS. DIAN JONES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1084 FULLER RD, LOUISBURG, NC 27549-7709
(919) 496-2958
Mailing address
1084 FULLER RD, LOUISBURG, NC 27549-7709
(919) 496-2958
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
MHL035017
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7803501
—
NC
Enumeration date
03/22/2007
Last updated
07/09/2007
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