Organization
TAR HEEL HABILITATION SERVICES LLC
Active
Other names
Tar Heel Day Services & Respite Division
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDRE PAUL GASTON J.D. (EXECUTIVE DIRECTOR)
(704) 431-4649
Entity
Organization
Contact information
Practice address
512 KLUMAC RD, SUITE #2, SALISBURY, NC 28144-6758
(704) 431-4649
Mailing address
512 KLUMAC RD, SUITE #2, SALISBURY, NC 28144-6758
(704) 431-4649
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
MHL-080-175
NC
Other
Enumeration date
10/04/2008
Last updated
10/04/2008
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