Organization
INTROSPECTION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LORI KING (EXECUTIVE DIRECTOR)
(919) 749-7128
Entity
Organization
Contact information
Practice address
10320 OLD CREEDMOOR RD, RALEIGH, NC 27613-6537
(919) 749-7128
Mailing address
10320 OLD CREEDMOOR RD, RALEIGH, NC 27613-6537
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Enumeration date
05/01/2010
Last updated
05/01/2010
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