Organization
LITE HOUSE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
K. CELESTE KIMBROUGH (DIRECTOR)
(910) 693-9903
Entity
Organization
Contact information
Practice address
26 PINECREST PLZ, #126, SOUTHERN PINES, NC 28387-4301
(910) 693-9903
Mailing address
120 W PENNSYLVANIA AVE, SUITE 27, SOUTHERN PINES, NC 28387-5429
(910) 693-9903
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3418042
—
NC
05
—
8301495
—
NC
Enumeration date
03/09/2007
Last updated
08/22/2020
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