Provider Demographics
NPI:1083861108
Name:HIDDEN TREASURES OF NC LLC
Entity Type:Organization
Organization Name:HIDDEN TREASURES OF NC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LACHANDA
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:BLACK
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:919-810-4906
Mailing Address - Street 1:406 W CARVER ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-2710
Mailing Address - Country:US
Mailing Address - Phone:919-810-4906
Mailing Address - Fax:919-471-6232
Practice Address - Street 1:3215 GUESS RD
Practice Address - Street 2:SUITE 101
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-2665
Practice Address - Country:US
Practice Address - Phone:919-810-4906
Practice Address - Fax:919-471-6232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services