Healthcare Provider Details

I. General information

NPI: 1881715548
Provider Name (Legal Business Name): THE LIFE CENTER OF DAVIDSON COUNTY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 02/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 W CENTER ST
LEXINGTON NC
27292-2715
US

IV. Provider business mailing address

601 W CENTER ST
LEXINGTON NC
27292-2715
US

V. Phone/Fax

Practice location:
  • Phone: 336-249-2155
  • Fax: 336-249-2374
Mailing address:
  • Phone: 336-249-2155
  • Fax: 336-249-2374

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateNC

VIII. Authorized Official

Name: MRS. ELIZABETH G. RUMMAGE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 336-249-2155