Care of Diversity, LLC

Organization Active NPI Adult Care Home Facility · Eden, NC

NPI 1457717548 · NPPES record last updated Jan 6, 2016

Key facts

NPI
1457717548
Entity type
Organization (NPI type 2)
Primary specialty
Adult Care Home Facility 311ZA0620X
License
FCL-079-101 (NC)
Legal business name
CARE OF DIVERSITY, LLC
Practice address
1235 Norman Dr
Apt 1B
Eden, NC 27288-5978
Phone
(336) 627-3336
NPI assigned
Jan 6, 2016
Organization subpart
No

Authorized official

Name
Senetra Reynolds
Title
Member/Administrator
Phone
(336) 627-3336

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X FCL-079-101 NC Yes

Addresses

Primary practice location

1235 Norman Dr
Apt 1B
Eden, NC 27288-5978

Mailing address

104 Boulevard
Eden, NC 27288-5220

Other providers in Eden, NC

All providers in Eden, NC · Adult Care Home Facility in North Carolina

Sources for this page

Verify at the official NPI Registry.