Organization
LEE COUNTY GROUP HOMES INC.
Active
Other names
Lee County Group Homes
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CELIA CAMERON COUSINS QPBS (DIRECTOR)
(919) 776-9189
Entity
Organization
Contact information
Practice address
2412 KNOLLWOOD DR, SANFORD, NC 27330-7671
(919) 776-9189
(919) 774-7711
Mailing address
1576 KELLY DR, SANFORD, NC 27330-6428
(919) 776-9189
(919) 774-7711
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
MHL-053-041
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7804514
—
NC
Enumeration date
03/19/2007
Last updated
08/22/2020
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