Organization
LIFETOUCH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RODNEY ANTONIO EDWARDS SR. BSQP (DIRECTOR/QP)
(336) 862-5013
Entity
Organization
Contact information
Practice address
414 OTTERAY AVE, HIGH POINT, NC 27262-2918
(276) 229-7927
Mailing address
1608 BALLARD CT, KERNERSVILLE, NC 27284-7936
(276) 229-7927
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
16235
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16235
—
NC
Enumeration date
03/27/2013
Last updated
03/27/2013
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