Organization
LLTJ ENTERPRISES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. THELMA SMITH I (CEO)
(919) 413-6933
Entity
Organization
Contact information
Practice address
110 SMOKEHOUSE LN, CARY, NC 27513-5431
(919) 413-6933
(919) 460-0776
Mailing address
110 SMOKEHOUSE LN, CARY, NC 27513-5431
(919) 413-6933
(919) 460-0776
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603806
—
NC
Enumeration date
10/11/2006
Last updated
04/28/2008
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