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Organization

A UNITED COMMUNITY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LISA STEPHENS BRADLEY (EXECUTIVE DIRECTOR)
(919) 912-1209
Entity
Organization

Contact information

Practice address
110 LAKE POINT DR, CLAYTON, NC 27527-5218
(919) 912-1209
Mailing address
105 LAKE POINT DR, CLAYTON, NC 27527-5217
(919) 912-1209

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
251S00000X
Community/Behavioral Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3410096
NC
05
8703098
NC
Enumeration date
11/19/2010
Last updated
08/08/2023
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