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
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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