Provider Demographics
NPI:1912789850
Name:UN1TY VILLAGE LLC
Entity type:Organization
Organization Name:UN1TY VILLAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENASIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:ALSTON-WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-724-6711
Mailing Address - Street 1:416 S MARIETTA ST
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28052-4332
Mailing Address - Country:US
Mailing Address - Phone:704-724-6711
Mailing Address - Fax:
Practice Address - Street 1:416 S MARIETTA ST
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28052-4332
Practice Address - Country:US
Practice Address - Phone:704-724-6711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities