LORD IS THE LIGHT


Address: 2802 Eldermont St, Apt E, Burlington, NC 27215-6111
Phone: 3362706217

LORD IS THE LIGHT (NPI# 1386956183) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1386956183
Entity Type Organization
Organization Name LORD IS THE LIGHT
Practice Address 2802 Eldermont St
Apt E
Burlington
NC 27215-6111
Practice Telephone 3362706217
Mailing Telephone 3362706217
Enumeration Date 2010-07-08
Last Update Date 2010-07-08
Authorized Official Name MS. KIMBERLY MICHELLE FOUST (OWNER)
Authorized Official Telephone 3362135830
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities MHL-001-196 NC Residential Treatment Facilities

Office Location

Street Address 2802 ELDERMONT ST
APT E
City BURLINGTON
State NC
Zip Code 27215-6111

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Taxonomy Information

Taxonomy Code 320600000X
Grouping Residential Treatment Facilities
Classification Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities

Taxonomy Definition

A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently.
Notes: [7/1/2003: new]

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NPI Name Taxonomy Address Enumeration
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1962825489 Signal Diymoke White Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 164 Graves St, Burlington, NC 27217-2628 2014-02-04
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City BURLINGTON
Zip Code 27215

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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