| Oliver Haywood Family Home Llc | |
| 254 Grovemere Ln Wendell NC 27591-9741 | |
| (919) 349-2473 | |
| Not Available | 
| Full Name | Oliver Haywood Family Home Llc | 
|---|---|
| Speciality | Community/behavioral Health | 
| Location | 254 Grovemere Ln, Wendell, North Carolina | 
| Authorized Official Name and Position | Shannon Graham (PRESIDENT) | 
| Authorized Official Contact | 9193492473 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Oliver Haywood Family Home Llc 254 Grovemere Ln Wendell NC 27591-9741 Ph: (919) 349-2473 | Oliver Haywood Family Home Llc 254 Grovemere Ln Wendell NC 27591-9741 Ph: (919) 349-2473 | 
| NPI Number | 1699460618 | 
|---|---|
| Provider Enumeration Date | 04/06/2023 | 
| Last Update Date | 04/06/2023 | 
| Certification Date | 04/06/2023 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1699460618 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary | 
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