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Organization

LILLIES RESIDENTIAL SERVICE'S

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LILLIE DORINE BRADLEY (OWNER)
(919) 353-2746
Entity
Organization

Contact information

Practice address
2168 LAKEWOOD FALLS RD, GOLDSTON, NC 27252-8916
(919) 353-2746
(919) 258-9830
Mailing address
3413 EVERS AVE, SANFORD, NC 27332-8519
(919) 353-2746
(919) 258-9830

Taxonomy

Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary

Other

Enumeration date
01/03/2008
Last updated
06/16/2008
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