Provider Demographics
NPI:1194099176
Name:WELL KEPT ADULT DAYCARE CENTER
Entity type:Organization
Organization Name:WELL KEPT ADULT DAYCARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:BOYCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-536-0383
Mailing Address - Street 1:216 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:WELDON
Mailing Address - State:NC
Mailing Address - Zip Code:27890-1548
Mailing Address - Country:US
Mailing Address - Phone:252-536-0383
Mailing Address - Fax:
Practice Address - Street 1:216 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:WELDON
Practice Address - State:NC
Practice Address - Zip Code:27890-1548
Practice Address - Country:US
Practice Address - Phone:252-536-0383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-08
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care