Organization
LIFE FOUNDATIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY LAWRENCE WHITTED (PRESIDENT)
(919) 572-0900
Entity
Organization
Contact information
Practice address
2314 S MIAMI BLVD, SUITE 156, DURHAM, NC 27703-5793
(919) 572-0900
(919) 572-0937
Mailing address
2314 S MIAMI BLVD, SUITE 156, DURHAM, NC 27703-5793
(919) 572-0900
(919) 572-0937
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8300989
—
NC
Enumeration date
07/20/2007
Last updated
07/20/2007
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