Provider Demographics
NPI:1750069167
Name:URBAN DLUXE LLC
Entity type:Organization
Organization Name:URBAN DLUXE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:JERMAINE
Authorized Official - Last Name:SCURRY
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:917-573-8493
Mailing Address - Street 1:2440 BAY HARBOR DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-4094
Mailing Address - Country:US
Mailing Address - Phone:917-573-8493
Mailing Address - Fax:
Practice Address - Street 1:2440 BAY HARBOR DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-4094
Practice Address - Country:US
Practice Address - Phone:917-573-8493
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)