Healthcare Provider Details

I. General information

NPI: 1477760130
Provider Name (Legal Business Name): LIGGINS FAMILY CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 06/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5231 HOPKINS RD
BROWNS SUMMIT NC
27214-9448
US

IV. Provider business mailing address

5231 HOPKINS RD
BROWNS SUMMIT NC
27214-9448
US

V. Phone/Fax

Practice location:
  • Phone: 336-275-7328
  • Fax: 336-272-6359
Mailing address:
  • Phone: 336-275-7328
  • Fax: 336-272-6359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License NumberFCL-041-030
License Number StateNC

VIII. Authorized Official

Name: GLENDA T LIGGINS
Title or Position: OWNER
Credential:
Phone: 336-275-7328