Provider Demographics
NPI:1235270778
Name:DK AMABASSADORS
Entity Type:Organization
Organization Name:DK AMABASSADORS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KARLUS
Authorized Official - Middle Name:
Authorized Official - Last Name:ARTIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-736-9943
Mailing Address - Street 1:908 E ELM ST
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27530-5914
Mailing Address - Country:US
Mailing Address - Phone:919-736-9943
Mailing Address - Fax:919-736-1186
Practice Address - Street 1:908 E ELM ST
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-5914
Practice Address - Country:US
Practice Address - Phone:919-736-9943
Practice Address - Fax:919-736-1186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services