Organization
UNLOCKING POTENTIAL RESIDENTIAL GROUP HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOMINIQUE DEMONTRELL ROBINSON (CEO)
(910) 551-1806
Entity
Organization
Contact information
Practice address
5025 WINDFLOWER DR, FAYETTEVILLE, NC 28314-0749
(910) 551-1806
Mailing address
6809 WOODMARK DR, FAYETTEVILLE, NC 28314-6458
(910) 551-1806
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/27/2024
Last updated
06/30/2024
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