Organization
LIFE ST. JOSEPH OF THE PINES, INC.
Active
Parent organization
ST JOSEPH OF THE PINES
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST JOSEPH OF THE PINES
Authorized official
MR. ROBERT LAWRENCE DICKSON (EXECUTIVE DIRECTOR)
(910) 429-7255
Entity
Organization
Contact information
Practice address
4900 RAEFORD RD, FAYETTEVILLE, NC 28304-3142
(910) 483-4911
Mailing address
4900 RAEFORD RD, FAYETTEVILLE, NC 28304-3142
(910) 483-4911
(910) 483-4930
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
PENDING
NC
Other
Enumeration date
06/25/2010
Last updated
02/08/2013
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