Provider Demographics
NPI:1659785418
Name:MRS.BEA'S DAY PROGRAM
Entity Type:Organization
Organization Name:MRS.BEA'S DAY PROGRAM
Other - Org Name:BEATRICE SELLERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DAY PROGRAM
Authorized Official - Prefix:MRS
Authorized Official - First Name:BEATRICE
Authorized Official - Middle Name:CASH
Authorized Official - Last Name:SELLERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-690-5786
Mailing Address - Street 1:1329 US HIGHWAY 52 S
Mailing Address - Street 2:
Mailing Address - City:WADESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28170-3193
Mailing Address - Country:US
Mailing Address - Phone:704-690-5786
Mailing Address - Fax:
Practice Address - Street 1:1672 WEST WALL ST
Practice Address - Street 2:
Practice Address - City:WADESBORO
Practice Address - State:NC
Practice Address - Zip Code:28170
Practice Address - Country:US
Practice Address - Phone:704-848-4020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-19
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251C00000X251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services