Healthcare Provider Details

I. General information

NPI: 1760349385
Provider Name (Legal Business Name): LILLIE MAE JAMES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 AMARILLO ROSE LN
DURHAM NC
27712-1481
US

IV. Provider business mailing address

809 AMARILLO ROSE LN
DURHAM NC
27712-1481
US

V. Phone/Fax

Practice location:
  • Phone: 919-525-9504
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: