Organization
LAGNIAPPE ENTERPRISES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN BERNARD HENRY (PRESIDENT/CEO)
(910) 985-0096
Entity
Organization
Contact information
Practice address
132 WILEY DR, CANDOR, NC 27229-9097
(910) 985-0096
(910) 974-7160
Mailing address
512 RIVERWIND DR, SPRING LAKE, NC 28390-8392
(910) 985-0096
(910) 974-7160
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/15/2010
Last updated
02/15/2010
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