Organization
LIZZA MAE PHILLIPS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIZZA MAE PHILLIPS (OWNER)
(252) 314-2530
Entity
Organization
Contact information
Practice address
2420 LIRIOPE DRIVE, ROCKY MOUNT, NC 27801-6292
(252) 314-2530
Mailing address
2420 LIRIOPE DRIVE, ROCKY MOUNT, NC 27801-6292
(252) 314-2530
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
—
—
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
02/18/2021
Last updated
02/18/2021
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