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NPI 1033304522

NPI 1033304522 : L.J. CHOICES, INC. : RED SPRINGS, NC

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General NPI Number Information
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    NPI Number           |    1033304522
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    Entity Type          |    Organization 
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    Legal Business Name  |    L.J. CHOICES, INC. 
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Dates
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    Enumeration Date     |    09/08/2007
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    Last Update Date     |    08/01/2008
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Provider Practice Location Address
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    Address Line         |    113 SOUTH EDINBOROUGH ST 
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    City                 |    RED SPRINGS
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    State                |    NC
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    Zip                  |    28377-1231
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    Country              |    US
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    Telephone            |    910-843-8210
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    Fax                  |    910-860-0594
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Provider Business Mailing Address
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    Address Line         |    5712 PROSPECTOR COURT 
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    City                 |    HOPE MILLS
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    State                |    NC
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    Zip                  |    28348-9372
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    Country              |    US
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    Telephone            |    910-308-7331
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    Fax                  |    910-860-0594
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Authorized Official
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    Title or Position    |    DIRECTOR
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    Name                 |     LINDA S JOHNSON 
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    Credential           |    
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    Telephone            |    910-308-7331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    322D00000X
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    Taxonomy Name        |    Emotionally Disturbed Childrens' Residential Treatment Facility
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    License Number       |    MHL-078-193
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    License Number State |    NC
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