Organization
BARBARA KING HOME AGENCY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOCKSLEY LISA MCFADDEN MD (ADMINSTRATOR)
(910) 988-3541
Entity
Organization
Contact information
Practice address
2932 BREEZEWOOD AVE STE 103, FAYETTEVILLE, NC 28303-5455
(910) 354-5459
(910) 304-6787
Mailing address
2932 BREEZEWOOD AVE STE 103, FAYETTEVILLE, NC 28303-5455
(910) 354-5459
(910) 304-6787
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
HC4613
NC
171W00000X
Contractor
HC4613
NC
225XM0800X
Mental Health Occupational Therapist
HC4613
NC
251E00000X
Home Health Agency
HC4613
NC
251G00000X
Community Based Hospice Care Agency
—
—
253J00000X
Foster Care Agency
HC4613
NC
253Z00000X
In Home Supportive Care Agency
Primary
HC4613
NC
282NR1301X
Rural Acute Care Hospital
HC4613
NC
302R00000X
Health Maintenance Organization
HC4613
NC
385HR2055X
Child Mental Illness Respite Care
—
—
390200000X
Student in an Organized Health Care Education/Training Program
HC4613
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
460910901
CAP DA
NC
05
—
460910901
—
NC
Enumeration date
01/02/2013
Last updated
09/27/2022
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