NPI 1033651070
Derek's Place
Practice location
- Address
- 150 Secret Garden Ln APT 1, Winston Salem, NC 27104-4721
- Phone
- (336) 671-3046
Authorised official
- Name
- Eric Hairston
- Title
- Executive Administrator
- Phone
- (336) 671-3046
Registered specialties (3)
Home Health Agency
Primary
Developmentally Disabled Services Day Training Agency
Child Intellectual and/or Developmental Disabilities Respite Care
Registry record
- NPI
- 1033651070
- Entity type
- Organization
- NPI issued
- 8 Nov 2016
- Record last updated
- 8 Nov 2016
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.