Provider Demographics
NPI:1679736524
Name:3 D'S FOREVER, INC
Entity Type:Organization
Organization Name:3 D'S FOREVER, INC
Other - Org Name:STEP DOWN GROUP HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:DANNAE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:CAMACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-210-6956
Mailing Address - Street 1:3012 BRANDERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-4908
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3012 BRANDERWOOD DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-4908
Practice Address - Country:US
Practice Address - Phone:336-833-1394
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-041-855320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities