Provider Demographics
NPI:1366588527
Name:LUTHERAN FAMILY SERVICES IN THE CAROLINAS
Entity type:Organization
Organization Name:LUTHERAN FAMILY SERVICES IN THE CAROLINAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AR SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:KENDALL
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-754-8232
Mailing Address - Street 1:PO BOX 2369
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28145
Mailing Address - Country:US
Mailing Address - Phone:704-637-2870
Mailing Address - Fax:704-637-2950
Practice Address - Street 1:1416 S MARTIN LUTHER KING JR AVE
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-5592
Practice Address - Country:US
Practice Address - Phone:704-637-2870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No253J00000XAgenciesFoster Care Agency
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8303236Medicaid
NC8301476Medicaid
NC8301476BMedicaid
NC8301476HMedicaid