Organization
FOTI ENTERPRISES, LLC
Active
Other names
Lifeway
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONYH FOTI SKLAVOUNAKIS (EXECUTIVE DIRECTOR)
(704) 807-6129
Entity
Organization
Contact information
Practice address
1639 SNEED RD, SHELBY, NC 28150-8105
(704) 807-6129
(704) 802-4213
Mailing address
1639 SNEED RD, SHELBY, NC 28150-8105
(704) 807-6129
(704) 802-4213
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
MHL-023-181
NC
Other
Enumeration date
06/25/2012
Last updated
06/25/2012
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