Organization
LIASION OUTPATIENT COMPLEX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVY CHAVIS LCSW (ADMINISTRATOR)
(919) 264-5450
Entity
Organization
Contact information
Practice address
105 EASTBROOK DR, GREENVILLE, NC 27858-4216
(252) 916-1233
(252) 689-6029
Mailing address
PO BOX 31062, GREENVILLE, NC 27833-1062
(919) 264-5450
(252) 689-6029
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/17/2014
Last updated
09/17/2014
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