Organization
LAKEWHEELER ROAD FAMILY CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY B MOSLAK (ADMINISTRATOR)
(919) 833-3763
Entity
Organization
Contact information
Practice address
1315 LAKE WHEELER RD, RALEIGH, NC 27603-2231
(919) 833-3763
(919) 833-3763
Mailing address
1315 LAKE WHEELER RD, RALEIGH, NC 27603-2231
(919) 833-3763
(919) 833-3763
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
FCL-092-017
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7802251
—
NC
Enumeration date
04/19/2007
Last updated
08/22/2020
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