Organization
CARDINAL CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEODORE W LANE PH.D. (MANAGING PARTNER)
(910) 867-8889
Entity
Organization
Contact information
Practice address
1540 PURDUE DRIVE, SUITE 200, FAYETTEVILLE, NC 28303-5510
(910) 867-8889
(910) 401-1024
Mailing address
1540 PURDUE DRIVE, SUITE 200, FAYETTEVILLE, NC 28303-5510
(910) 867-8889
(910) 401-1024
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
253J00000X
Foster Care Agency
—
—
Other
Enumeration date
09/23/2010
Last updated
09/23/2010
Update your record
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