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Organization

LIFE BASED CONCEPTIONS, LLC

Active
Other names
LBC
Organization subpart
No

Provider details

NPI number
Authorized official
MR. REGINALD GILES CARTER QMHP (COMMUNITY SUPPORT PROFESSIONAL)
(919) 403-6160
Entity
Organization

Contact information

Practice address
2144 PAGE RD, SUITE 102, DURHAM, NC 27703-5952
(919) 403-6160
(919) 640-8810
Mailing address
2144 PAGE ROAD, STE 102, DURHAM, NC 27703-2564
(919) 403-6160
(919) 640-8810

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
NC
251S00000X
Community/Behavioral Health Agency
Primary
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3418491
NC
05
8302408
NC
Enumeration date
10/22/2007
Last updated
08/21/2013
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