Provider Demographics
NPI:1932302361
Name:DUNN'S HOUSE OF LOVE AND DEVOTED CARE, INC.
Entity Type:Organization
Organization Name:DUNN'S HOUSE OF LOVE AND DEVOTED CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CLINTON
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-978-4968
Mailing Address - Street 1:1846 E TRAIL DR SE
Mailing Address - Street 2:1812 BIRCHWOOD DR.
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-8732
Mailing Address - Country:US
Mailing Address - Phone:910-978-4968
Mailing Address - Fax:252-296-0008
Practice Address - Street 1:1846 E TRAIL DR SE
Practice Address - Street 2:1812 BIRCHWOOD DR.
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-8732
Practice Address - Country:US
Practice Address - Phone:910-978-4968
Practice Address - Fax:252-296-0008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-098-120251T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization