Organization
LIFE STAGES INTEGRATED SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROSCOE FULMORE (DIRECTOR OF OPERATIONS)
(252) 327-4231
Entity
Organization
Contact information
Practice address
2407 GRACE AVE, SUITE 5, NEW BERN, NC 28562-4416
(252) 327-4231
(252) 355-7287
Mailing address
2407 GRACE AVE, SUITE 5, NEW BERN, NC 28562-4416
(252) 327-4231
(252) 355-7287
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
01/21/2008
Last updated
01/21/2008
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