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General NPI Number Information
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NPI Number | 1518267236
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Entity Type | Organization
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Legal Business Name | LIVING HOPE AGENCY LLC
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Dates
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Enumeration Date | 10/27/2010
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Last Update Date | 10/27/2010
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Provider Practice Location Address
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Address Line | 1908 CEDAR POINT CIR
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City | ELIZABETH CITY
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State | NC
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Zip | 27909-9695
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Country | US
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Telephone | 252-340-6473
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Fax |
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Provider Business Mailing Address
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Address Line | 1908 CEDAR POINT CIR
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City | ELIZABETH CITY
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State | NC
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Zip | 27909-9695
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Country | US
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Telephone | 252-340-6473
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | TERRICA MITCHELL
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Credential |
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Telephone | 252-340-6473
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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