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General NPI Number Information
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NPI Number | 1467995464
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Entity Type | Organization
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Legal Business Name | PRECIOUS ANGEL CHILDCARE
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Dates
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Enumeration Date | 11/22/2016
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Last Update Date | 11/22/2016
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Provider Practice Location Address
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Address Line | 4101 PIN OAK RD
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City | RALEIGH
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State | NC
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Zip | 27604-4720
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Country | US
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Telephone | 919-862-0602
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Fax |
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Provider Business Mailing Address
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Address Line | 4101 PIN OAK RD
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City | RALEIGH
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State | NC
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Zip | 27604-4720
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/ DIRECTOR
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Name | DIANA THORPE
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Credential |
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Telephone | 919-862-0602
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 92002680
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License Number State | NC
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