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General NPI Number Information
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NPI Number | 1518309731
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Entity Type | Organization
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Legal Business Name | LILA COMMUNITY ENHANCE SERVICES INC.
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Dates
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Enumeration Date | 07/30/2013
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Last Update Date | 07/30/2013
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Provider Practice Location Address
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Address Line | 7126 FOUNDERS WAY
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City | HARRISBURG
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State | NC
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Zip | 28075-9443
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Country | US
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Telephone | 980-298-5181
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Fax |
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Provider Business Mailing Address
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Address Line | 13178 NC HIGHWAY 130 E
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City | FAIRMONT
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State | NC
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Zip | 28340-9597
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Country | US
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Telephone | 910-535-4168
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Fax | 910-535-4184
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Authorized Official
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Title or Position | DIRECTOR
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Name | DAVID CURTIS
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Credential | BSW MA
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Telephone | 980-298-5181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | MHL078207
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License Number State | NC
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Taxonomy #2
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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 | MHL078207
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License Number State | NC
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