Healthcare Provider Details
I. General information
NPI: 1902925696
Provider Name (Legal Business Name): TOPPER HOUSE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/27/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3811 FAWN CREEK DR
WILMINGTON NC
28409-3277
US
IV. Provider business mailing address
3020 BROOKCROSSING DR VILLAGE AT LAKEWOOD
FAYETTEVILLE NC
28306-9790
US
V. Phone/Fax
- Phone: 910-273-5838
- Fax:
- Phone: 910-429-0954
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
MARC
WEINSTOCK
Title or Position: OWNER
Credential:
Phone: 910-429-0954