Organization
NATIVE AMERICAN INTERFAITH MINISTRIES
Active
Other names
The Healing Lodge
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TONY VINCENT LOCKLEAR (EXECUTIVE DIRECTOR)
(910) 522-0900
Entity
Organization
Contact information
Practice address
450 PROSPECT ROAD, PEMBROKE, NC 28372
(910) 522-0900
Mailing address
PO BOX 1695, PEMBROKE, NC 28372-1695
(910) 522-0900
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
NC
Other
Enumeration date
12/17/2007
Last updated
12/17/2007
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