Evans Walston Home LLC
NPI #1063843274 in Fuquay Varina, North Carolina
Provider Information
- NPI Number
- 1063843274
- Entity Type
- Organization
- Organization Name
- Evans Walston Home LLC
- Primary Specialty
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Dec 13, 2013
- Last Updated
- Dec 13, 2013
Practice Location
- Address
- 808 HAWKS VIEW CT
- City
- Fuquay Varina
- State
- North Carolina
- ZIP Code
- 27526-6642
- Phone
- (919) 552-1312
Authorized Official
- Name
- MRS. GLENDA JUDD EVANS WALSTON
- Title
- OWNER/OPERATOR
- Phone
- (919) 552-1312
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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