Organization
LIFE LINE COMMUNITY OUTREACH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERNESTINE K JULUE (EXECUTIVE DIRECTOR/ OWNER)
(919) 744-5446
Entity
Organization
Contact information
Practice address
10705 NED CT, 21, CHARLOTTE, NC 28273-9152
(919) 744-5446
Mailing address
10705 NED CT, 21, CHARLOTTE, NC 28273-9152
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
11/28/2012
Last updated
11/28/2012
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