Organization
I AM LIGHT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANQUINARTA LEE B.A., MA ED., NCC (OWNER)
(910) 301-7752
Entity
Organization
Contact information
Practice address
4813 CASTLE HILL RD, RALEIGH, NC 27616-6273
(910) 301-7752
Mailing address
4813 CASTLE HILL RD, RALEIGH, NC 27616-6273
(910) 301-7752
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
09/28/2022
Last updated
09/28/2022
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