Organization
LIFEQUEST DISABILITIES SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANE B WILLIAMS BA/QP (PRESIDENT)
(910) 389-0901
Entity
Organization
Contact information
Practice address
231 NEW BRIDGE ST, JACKSONVILLE, NC 28540-4736
(910) 430-4152
(910) 430-4310
Mailing address
325 BANNERMANS MILL RD, RICHLANDS, NC 28574-8105
(910) 389-0901
(910) 430-4310
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3418747
—
NC
Enumeration date
11/04/2009
Last updated
08/06/2014
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