Provider Demographics
NPI:1407979941
Name:GREAT EXPECTATION DAY FACILITY AND ENRICHMENT PROGRAM
Entity Type:Organization
Organization Name:GREAT EXPECTATION DAY FACILITY AND ENRICHMENT PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:LYDIA
Authorized Official - Last Name:STRANGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-425-8218
Mailing Address - Street 1:5587 SON TAY CT
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-2246
Mailing Address - Country:US
Mailing Address - Phone:910-425-8218
Mailing Address - Fax:
Practice Address - Street 1:3421 MURCHISON RD STE J
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28311-2800
Practice Address - Country:US
Practice Address - Phone:910-488-3107
Practice Address - Fax:910-488-3149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Single Specialty