# LANE HOME

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

## Provider details

- **NPI number:** 1578628574
- **Authorized official:** MS. SUE BATTEN LANE (DIRECTOR)
- **Authorized official phone:** (919) 965-8407

## Contact information

- **Practice address:** 3620 LIZZIE MILL RD, SELMA, NC 27576-8603
- **Practice address phone:** (919) 965-8407
- **Practice address fax:** (919) 965-8409
- **Mailing address:** 3620 LIZZIE MILL RD, SELMA, NC 27576-8603
- **Mailing address phone:** (919) 965-8407
- **Mailing address fax:** (919) 965-8409

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | MHL-051-048 | NC | Yes |

## Other

- **Enumeration date:** 12/27/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 6603522 | — | NC |