Organization
LUTHERAN FAMILY SERVICES IN THE CAROLINAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRBY NICKERSON (CFO)
(704) 637-2870
Entity
Organization
Contact information
Practice address
6590 ROLLINGWOOD DR, CLEMMONS, NC 27012-9119
(336) 766-9833
Mailing address
PO BOX 2369, SALISBURY, NC 28145
(704) 637-2870
(704) 637-2950
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
MHL034174
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7804965
—
NC
05
—
8301054
—
NC
05
—
8301054B
—
NC
Enumeration date
01/26/2007
Last updated
06/26/2017
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