Organization
LIFE SOLUTIONS
Active
Other names
Bridgecrest
Organization subpart
No
Provider details
NPI number
Authorized official
MARREA EVANS (OWNER)
(910) 272-0161
Entity
Organization
Contact information
Practice address
210 EAST FAYETTEVILLE STREET, LUMBER BRIDGE, NC 28357-9999
(910) 843-3758
Mailing address
401 E 11TH ST, LUMBERTON, NC 28358-4807
(910) 272-0161
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
MHL078009
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603744
—
NC
Enumeration date
09/11/2007
Last updated
03/04/2008
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