Provider Demographics
NPI:1386880987
Name:C-LOU'S FAMILY SERVICES
Entity type:Organization
Organization Name:C-LOU'S FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-695-2922
Mailing Address - Street 1:PO BOX 473
Mailing Address - Street 2:
Mailing Address - City:LILESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28091-0473
Mailing Address - Country:US
Mailing Address - Phone:704-695-2922
Mailing Address - Fax:
Practice Address - Street 1:HWY 74 WEST
Practice Address - Street 2:
Practice Address - City:WADESBORO
Practice Address - State:NC
Practice Address - Zip Code:28170
Practice Address - Country:US
Practice Address - Phone:704-695-2922
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-02
Last Update Date:2009-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health