Organization
LIFT DAY ACTIVITY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BRENDEX RENEA MEEKS (OFFICE ADMINISTRATOR)
(919) 569-9566
Entity
Organization
Contact information
Practice address
701 E YOUNG STREET, ROLESVILLE, NC 27571
(919) 569-9566
(919) 569-0269
Mailing address
PO BOX 1383, WENDELL, NC 27591-1383
(919) 569-9566
(919) 569-0269
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
MHL-092-742
NC
Other
Enumeration date
05/21/2009
Last updated
05/21/2009
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