Organization
MS. JANE'S PROFESSINAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL LYNETTE LUCAS (CEO)
(910) 733-5166
Entity
Organization
Contact information
Practice address
525 WOODS RD, PEMBROKE, NC 28372-8099
(910) 733-5166
(910) 521-7435
Mailing address
525 WOODS RD, PEMBROKE, NC 28372-8099
(910) 733-5166
(910) 521-7435
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
078223
NC
Other
Enumeration date
04/07/2009
Last updated
04/07/2009
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