# LIFEPATH LLC

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

## Provider details

- **NPI number:** 1942595590
- **Authorized official:** THERESHA HILL (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (336) 255-3367

## Contact information

- **Practice address:** 5908 S NC HIGHWAY 49, BURLINGTON, NC 27215-9621
- **Practice address phone:** (336) 255-3367
- **Mailing address:** 4565 VERNON FARMS BLVD, KERNERSVILLE, NC 27284-0130

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | — | Yes |

## Other

- **Enumeration date:** 06/11/2011
- **Last updated:** 06/11/2011