# SEDALIA CENTER \#2

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063624641
- **Authorized official:** MS. GLENDA T LIGGINS (OWNER)
- **Authorized official phone:** (336) 275-7328

## Contact information

- **Practice address:** 6143 BLUE LANTERN RD, GIBSONVILLE, NC 27249-8737
- **Practice address phone:** (336) 275-7328
- **Practice address fax:** (336) 272-6359
- **Mailing address:** 6143 BLUE LANTERN RD, GIBSONVILLE, NC 27249-8737
- **Mailing address phone:** (336) 275-7328
- **Mailing address fax:** (336) 272-6359

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | FCL-041-070 | NC | Yes |

## Other

- **Enumeration date:** 05/04/2007
- **Last updated:** 03/05/2010