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Organization
LAKEVIEW
Active
Organization
LAKEVIEW
Active
Parent organization
RENU LIFE, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
RENU LIFE, LLC
Authorized official
MRS. DIANE HARRISON (PRESIDENT)
(919) 734-0266
Entity
Organization
Contact information
Practice address
103 LAKEVIEW DR, GOLDSBORO, NC 27530-1125
(919) 734-0266
(919) 734-9926
Mailing address
PO BOX 1017, GOLDSBORO, NC 27533-1017
(919) 734-0266
(919) 734-9926
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL-096-092
NC
Other
Enumeration date
05/19/2009
Last updated
05/19/2009
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