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Organization

LEE'S FAMILY CARE HOME

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. WILLIE JAMES LEE (ADMINISTRATOR)
(919) 853-3359
Entity
Organization

Contact information

Practice address
945 VAIDEN ROAD, LOUISBURG, NC 27549-8096
(919) 853-3359
(919) 853-3359
Mailing address
945 VAIDEN RD, LOUISBURG, NC 27549-8096
(919) 853-3359
(919) 853-3359

Taxonomy

Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
Primary
FCL035-002
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
900-47-3245-0
NC
05
900-85-1645-0
NC
05
945-00-6722-S
NC
05
947-58-7594-S
NC
Enumeration date
09/07/2007
Last updated
09/07/2007
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