Organization
LOVING LIGHT COMMUNITY OUTREACH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS ANTONIO STEPHENSON (DIRECTOR)
(252) 673-0652
Entity
Organization
Contact information
Practice address
403 ATLANTIC AVE, ROCKY MOUNT, NC 27801-5313
(252) 673-0652
Mailing address
313 HIGHWAY 158 BUSINESS, MURFREESBORO, NC 27855
(252) 673-0652
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
01/31/2018
Last updated
01/31/2018
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