Organization
FAMILY QUALITY CARE SERVICE ,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SANDRA DENISE LASSITER (CHIEF EXECUTIVE OFFICER)
(919) 237-2225
Entity
Organization
Contact information
Practice address
1812 LIBERTY ST, DURHAM, NC 27703-2271
(919) 237-2225
(919) 237-2225
Mailing address
PO BOX 11265, DURHAM, NC 27703-0265
(919) 237-2225
(919) 237-2226
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
251300000X
Local Education Agency (LEA)
Primary
032-328
NC
251B00000X
Case Management Agency
032-328
NC
251C00000X
Developmentally Disabled Services Day Training Agency
032-328
NC
251E00000X
Home Health Agency
HC2967
NC
251S00000X
Community/Behavioral Health Agency
032-328
NC
261QH0100X
Health Service Clinic/Center
032-328
NC
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
032-038
NC
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
032-328
NC
261QM0855X
Adolescent and Children Mental Health Clinic/Center
032-328
NC
347C00000X
Private Vehicle
032-328
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
251E00000X
—
NC
05
—
261QM0801X
—
NC
05
—
261QM0850X
—
NC
Enumeration date
12/19/2006
Last updated
09/26/2007
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