Gahc3 Wake Forest Nc Trs Sub, LLC
NPI #1710538160 in Wake Forest, North Carolina
Provider Information
- NPI Number
- 1710538160
- Entity Type
- Organization
- Organization Name
- Gahc3 Wake Forest Nc Trs Sub, LLC
- Primary Specialty
- Custodial Care Facility
- Enumeration Date
- Sep 26, 2019
- Last Updated
- Oct 30, 2019
Practice Location
- Address
- 3218 HERITAGE TRADE DR
- City
- Wake Forest
- State
- North Carolina
- ZIP Code
- 27587-4238
- Phone
- (919) 569-2101
Authorized Official
- Name
- DANNY PROSKY
- Title
- PRESIDENT
- Phone
- (949) 270-9200
Specialties & Taxonomy Codes
| Specialty |
|---|
| Custodial Care Facility - Adult Care Home — Adult Care Home |
| Custodial Care Facility |
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