Organization
LUCILLE'S BEHAVIORAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATRICIA SAULS PHILLIPS (DIRECTOR)
(252) 747-1001
Entity
Organization
Contact information
Practice address
204 HWY 58 N, SNOW HILL, NC 28580-8402
(252) 574-7100
(252) 747-1001
Mailing address
204 HWY 58 N, SNOW HILL, NC 28580-8402
(252) 574-7100
(252) 747-1001
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL040018
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3409488
—
NC
05
—
7805142
—
NC
05
—
8300985
—
NC
Enumeration date
12/01/2006
Last updated
08/22/2020
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