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General NPI Number Information
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NPI Number | 1710071238
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Entity Type | Organization
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Legal Business Name | ELDO, INC.
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 02/12/2010
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Provider Practice Location Address
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Address Line | 1803 CASTLE ST
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City | WILMINGTON
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State | NC
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Zip | 28403-2103
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Country | US
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Telephone | 910-763-5873
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Fax | 910-762-3115
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Provider Business Mailing Address
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Address Line | 1805 CASTLE ST
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City | WILMINGTON
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State | NC
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Zip | 28403-2103
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Country | US
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Telephone | 910-762-3118
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Fax | 910-762-3115
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. YOLANDA PARKER RANDOLPH
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Credential | M.A.
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Telephone | 910-762-3118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | FCL065013
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License Number State | NC
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