Organization
EASTER SEALS UCP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANDREA DENISE LANE LCAS-A (SUBSTANCE ABUSE)
(919) 274-8356
Entity
Organization
Contact information
Practice address
4038 CAPITAL DR, ROCKY MOUNT, NC 27804-3123
(252) 467-2860
Mailing address
4038 CAPITAL DR, ROCKY MOUNT, NC 27804-3123
(252) 467-2860
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-A
NC
Other
Enumeration date
03/25/2015
Last updated
03/25/2015
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