Provider Demographics
NPI:1841540663
Name:EDUCATION UNLIMITED DAY PROGRAM CENTERS
Entity type:Organization
Organization Name:EDUCATION UNLIMITED DAY PROGRAM CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:GOSLEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-630-3041
Mailing Address - Street 1:1446 PAMALEE DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-3928
Mailing Address - Country:US
Mailing Address - Phone:910-630-3041
Mailing Address - Fax:
Practice Address - Street 1:1448 PAMALEE DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-3928
Practice Address - Country:US
Practice Address - Phone:910-630-3940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL - 026 - 858251C00000X
NCMHL - 026 - 859251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services