Organization
BLACK EXCELLENCE STRIVING THERAPEUTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARCUS DEONTOINE BEST MASTERS (QUALIFIED PROFESSIONAL)
(919) 879-6090
Entity
Organization
Contact information
Practice address
142 SOUTHERN PLAZA DR, DUDLEY, NC 28333-9159
(919) 879-6090
Mailing address
PO BOX 771, CLAYTON, NC 27528-0771
(919) 879-6090
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
Other
Enumeration date
03/15/2024
Last updated
03/15/2024
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