Organization
FAMILY LEGACY MENTAL HEALTH SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA DYAN STACEY B.S. Q.P (CEO)
(919) 834-2000
Entity
Organization
Contact information
Practice address
1011 SCHAUB DR, SUITE 200, RALEIGH, NC 27606-1862
(919) 834-2000
(919) 834-2001
Mailing address
1011 SCHAUB DR, SUITE 200, RALEIGH, NC 27606-1862
(919) 834-2000
(919) 834-2001
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3410107
—
NC
05
—
8703109
—
NC
Enumeration date
12/10/2010
Last updated
01/27/2014
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