Miss Daisy's Gentlemen of the Future Inc.
NPI #1033204300 in Wilson, North Carolina
Provider Information
- NPI Number
- 1033204300
- Entity Type
- Organization
- Organization Name
- Miss Daisy's Gentlemen of the Future Inc.
- Primary Specialty
- Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Oct 4, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 304 FAIRVIEW AVE SW
- City
- Wilson
- State
- North Carolina
- ZIP Code
- 27893-4817
- Phone
- (252) 293-4683
Authorized Official
- Name
- MRS. TONYA FULLER JOHNSON
- Title
- DIRECTOR/QUALIFIED PROFESSIONAL
- Phone
- (252) 363-5446
Specialties & Taxonomy Codes
| Specialty |
|---|
| Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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