=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083804314
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE LAWSON'S HOUSE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/01/2007
-----------------------------------------------------
Last Update Date | 08/01/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 745 US HIGHWAY 117 S
-----------------------------------------------------
City | BURGAW
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28425
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-259-0238
-----------------------------------------------------
Fax | 910-259-0239
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 317
-----------------------------------------------------
City | HARRELLS
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28444-0317
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | SHARITA M LAWSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 910-409-8476
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------