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General NPI Number Information
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NPI Number | 1669640967
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Entity Type | Organization
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Legal Business Name | LAMONTE D. DUNLAP
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Dates
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Enumeration Date | 02/20/2008
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 2013 GRAMERCY PARK DR
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City | GREENSBORO
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State | NC
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Zip | 27406-8566
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Country | US
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Telephone | 336-587-1678
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Fax |
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Provider Business Mailing Address
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Address Line | 2013 GRAMERCY PARK DR
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City | GREENSBORO
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State | NC
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Zip | 27406-8566
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Country | US
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Telephone | 336-587-1678
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. LAMONTE DEWAYNE DUNLAP
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Credential |
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Telephone | 336-587-1678
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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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 |
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License Number State |
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