Provider Demographics
NPI:1154516565
Name:L & L FAMILY CARE
Entity type:Organization
Organization Name:L & L FAMILY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITTED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-274-1316
Mailing Address - Street 1:1215 MOODY ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-4216
Mailing Address - Country:US
Mailing Address - Phone:336-274-1316
Mailing Address - Fax:336-275-8091
Practice Address - Street 1:1215 MOODY ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-4216
Practice Address - Country:US
Practice Address - Phone:336-274-1316
Practice Address - Fax:336-275-8091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL-041-015320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness