Organization
LIFT RESPONDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MYRON JEREL KING (OWNER)
(919) 902-3414
Entity
Organization
Contact information
Practice address
8108 BURGWYN LN, WILLOW SPRING, NC 27592
(919) 902-3414
Mailing address
8108 BURGWYN LN, WILLOW SPRING, NC 27592-8960
(919) 902-3414
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
05/08/2018
Last updated
05/29/2018
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