# LAKEWHEELER ROAD FAMILY CARE HOME

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

## Provider details

- **NPI number:** 1689891814
- **Authorized official:** MRS. MARY B MOSLAK (ADMINISTRATOR)
- **Authorized official phone:** (919) 833-3763

## Contact information

- **Practice address:** 1315 LAKE WHEELER RD, RALEIGH, NC 27603-2231
- **Practice address phone:** (919) 833-3763
- **Practice address fax:** (919) 833-3763
- **Mailing address:** 1315 LAKE WHEELER RD, RALEIGH, NC 27603-2231
- **Mailing address phone:** (919) 833-3763
- **Mailing address fax:** (919) 833-3763

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320700000X | Physical Disabilities Residential Treatment Facility | FCL-092-017 | NC | Yes |

## Other

- **Enumeration date:** 04/19/2007
- **Last updated:** 08/22/2020