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General NPI Number Information
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NPI Number | 1235276031
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Entity Type | Organization
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Legal Business Name | UNITED RESIDENTIAL SERVICES OF N.C.
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 04/23/2009
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Provider Practice Location Address
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Address Line | 6503 KEMPER CT
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City | FAYETTEVILLE
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State | NC
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Zip | 28303-2354
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Country | US
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Telephone | 910-583-1104
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Fax | 910-630-1104
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Provider Business Mailing Address
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Address Line | PO BOX 25928
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City | FAYETTEVILLE
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State | NC
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Zip | 28314-5015
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Country | US
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Telephone | 910-583-1104
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Fax | 910-630-1104
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Authorized Official
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Title or Position | FACILITY DIRECTOR
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Name | DARRIN LEE MCNEILL
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Credential |
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Telephone | 910-583-1104
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number | 047-068
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number | 026-694
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License Number State | NC
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