Provider Demographics
NPI:1710244454
Name:A GREAT DAY ENRICHMENT CENTER
Entity Type:Organization
Organization Name:A GREAT DAY ENRICHMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:OLIVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-628-7115
Mailing Address - Street 1:1909 HORNE CAMP RD
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28340-8787
Mailing Address - Country:US
Mailing Address - Phone:910-628-7115
Mailing Address - Fax:
Practice Address - Street 1:1909 HORNE CAMP RD
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:NC
Practice Address - Zip Code:28340-8787
Practice Address - Country:US
Practice Address - Phone:910-628-7115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-078-296261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health