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General NPI Number Information
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NPI Number | 1861863805
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Entity Type | Organization
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Legal Business Name | SECOND TOUCH LLC
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Dates
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Enumeration Date | 10/16/2015
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Last Update Date | 10/16/2015
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Provider Practice Location Address
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Address Line | 2528 1/2 POOLE RD
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City | RALEIGH
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State | NC
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Zip | 27610-2820
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Country | US
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Telephone | 919-900-7086
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Fax |
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Provider Business Mailing Address
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Address Line | 2528 1/2 POOLE RD
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City | RALEIGH
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State | NC
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Zip | 27610-2820
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Country | US
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Telephone | 919-900-7086
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. ELVALORIE MATTHEWS
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Credential |
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Telephone | 919-600-1505
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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 | 1475469
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License Number State | NC
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