Organization
LEE COUNTY GROUP HOMES, INC.
Active
Other names
Lee # 1 and Lee # 2
Organization subpart
No
Provider details
NPI number
Authorized official
CELIA C COUSINS QPBS (EXECUTIVE DIRECTOR)
(919) 776-9189
Entity
Organization
Contact information
Practice address
3101 CARBONTON RD, LEE # 1, SANFORD, NC 27330-8214
(919) 776-9189
(919) 774-7711
Mailing address
PO BOX 1373, SANFORD, NC 27331-1373
(919) 776-9189
(919) 774-7711
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL 053039
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7804513
—
NC
Enumeration date
09/16/2006
Last updated
08/22/2020
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