Organization
LIGHT & ROD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SABRINA CHELSEA SISOUNONG M.A. BCBA, LBA (OWNER, BCBA)
(860) 578-0832
Entity
Organization
Contact information
Practice address
999 PEPPERWOOD DR, FAYETTEVILLE, NC 28311-9387
(860) 578-0832
Mailing address
999 PEPPERWOOD DR, FAYETTEVILLE, NC 28311-9387
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
05/15/2024
Last updated
05/22/2024
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