Organization
PEACE LILY DEVELOPMENT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY LEWIS (ADMINISTRATOR)
(336) 386-8074
Entity
Organization
Contact information
Practice address
103 PEACE LILLY LN, DOBSON, NC 27017-8483
(336) 386-8074
(336) 386-8394
Mailing address
PO BOX 705, DOBSON, NC 27017-0705
(336) 386-8074
(336) 386-8394
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
MHL086034
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7803740
—
NC
Enumeration date
12/22/2006
Last updated
07/28/2008
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