Lifegate Residential Care

NPI 1023234671 - Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities - 320600000X

NPI Details
NPI 1023234671
Enumeration Date 04/18/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name CLEOLA MAE CLEOLA
Position PROGRAM MANAGER
Phone (919) 639-2777
Fax (919) 779-2955
Practice Location
209 WHITE OAK FARMS DR
WILLOW SPRING NC, 27592-8534, US
Phone (919) 639-2777
Fax (919) 779-2955
Business Location
209 WHITE OAK FARMS DR
WILLOW SPRING NC, 27592-8534, US
Phone (919) 639-2777
Fax (919) 779-2955
Toxanomy
Taxonomy Code 320600000X
License State North Carolina
License Number MHL-051-157NC
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According to our database, Lifegate Residential Care NPI is 1023234671, taxonomy code is 320600000X and license number is MHL-051-157NC, license state is located at North Carolina. Lifegate Residential Care physically located at 209 White Oak Farms Dr, Willow Spring NC, 27592-8534. NPI Number 1033115704 has the healthcare provider type.

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1023234671 NPI number is provided on an as is basis without warranty of any kind. 1023234671 is maintained by the National Plan & Provider Enumeration System. The contents of Lifegate Residential Care are for informational purposes only.