MEDICARE: LUCILLE'S BEHAVIORAL, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility	MHL040018	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649348483
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUCILLE'S BEHAVIORAL, INC.

Provider Business Mailing Address
First Line	:	204 HWY 58 N
Second Line	:
City	:	SNOW HILL
State	:	NC
Zip	:	28580-8402
Country	:	US
Telephone Number	:	252-574-7100
Fax Number	:	252-747-1001

Provider Business Practice Location Address
First Line	:	204 HWY 58 N
Second Line	:
City	:	SNOW HILL
State	:	NC
Zip	:	28580-8402
Country	:	US
Telephone Number	:	252-574-7100
Fax Number	:	252-747-1001

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. PATRICIA SAULS PHILLIPS
Credential	:
Telephone Number	:	252-747-1001

Provider Enumeration Date	:	12/01/2006
Last Update Date	:	08/22/2020

Similar Medicare Providers

1114147733 — COURTYARD ESTATES AT CEDAR POINTE
Practice Location Address:

6132 NE 12TH AVE
PLEASANT HILL, IA
50327-8402

Practice Phone: 515-285-9108
Practice Fax:

1891798054 — GREENE COUNTY HEALTH CARE INCORPORATED
Practice Location Address:

1106 KINGOLD BLVD
SNOW HILL, NC
28580-1619

Practice Phone: 252-747-2921
Practice Fax: 252-221-5879

1568464386 — GREENE COUNTY HEALTH CARE INCORPORATED
Practice Location Address:

6 PROFESSIONAL DR
SNOW HILL, NC
28580-1333

Practice Phone: 252-747-3846
Practice Fax: 252-747-2466

1083616809 — GREENE COUNTY HEALTH CARE INCORPORATED
Practice Location Address:

140 SCHOOL DR
SNOW HILL, NC
28580-7288

Practice Phone: 252-747-5841
Practice Fax: 252-747-4916

1700888542 — GREENE COUNTY HEALTH CARE INCORPORATED
Practice Location Address:

205 MARTIN L KING JR PKWY
SNOW HILL, NC
28580-1320

Practice Phone: 252-747-4199
Practice Fax: 252-221-5308

1326025610 — MS. DEBRA FELL FNP
Practice Location Address:

190 CAROLINA DR
SNOW HILL, NC
28580-1651

Practice Phone: 252-747-2204
Practice Fax: 252-747-2210

Directions to “LUCILLE'S BEHAVIORAL, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.