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Organization
LANE HOME
Active
Organization
LANE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUE BATTEN LANE (DIRECTOR)
(919) 965-8407
Entity
Organization
Contact information
Practice address
3620 LIZZIE MILL RD, SELMA, NC 27576-8603
(919) 965-8407
(919) 965-8409
Mailing address
3620 LIZZIE MILL RD, SELMA, NC 27576-8603
(919) 965-8407
(919) 965-8409
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-051-048
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603522
—
NC
Enumeration date
12/27/2006
Last updated
08/22/2020
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