LIVING WELL BEHAVIORAL HEALTH LAB (NPI# 1619349107) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619349107 |
| Entity Type | Organization |
| Organization Name | LIVING WELL BEHAVIORAL HEALTH LAB |
| Practice Address |
2350 Bentridge Ln Ste 301a Fayetteville NC 28304-0590 |
| Practice Telephone | 9107480261 |
| Practice Fax Number | 9107589358 |
| Mailing Telephone | 9107480261 |
| Mailing Fax Number | 9107589358 |
| Enumeration Date | 2015-10-23 |
| Last Update Date | 2019-10-29 |
| Authorized Official Name | PATRICIA DELEURAN (PRESIDENT) |
| Authorized Official Telephone | 9198032111 |
| Is Organization Subpart | Y |
| Parent Organization Name | LIVING WELL BEHAVIORAL HEALTH, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | Laboratories |
| Street Address |
2350 BENTRIDGE LN STE 301A |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28304-0590 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301061 | Coast To Coast Bilingual Counseling | Social Worker | 910 Hope Mills Road, Fayetteville, NC 28304 | 2019-11-20 |
| 1811530561 | Frances L. Hurst | Technician | 6732 Carloway Dr, Fayetteville, NC 28304 | 2019-10-25 |
| 1538717764 | Rose Mary A O'conner | Technician | 3530 Madison Ave, Fayetteville, NC 28304 | 2019-08-30 |
| 1932756087 | Sally Frances Jones | Technician | 2053 Mango Circle, Fayetteville, NC 28304 | 2019-08-23 |
| 1326528803 | Jeneen Yvette Townsend | Counselor | 2671 Adams Lake Dr Apt F, Fayetteville, NC 28304 | 2018-08-15 |
| 1780179580 | Ma Cornelia Villavicencio Leano | Nurse Practitioner | 3081 Stone Carriage Cir Apt Z, Fayetteville, NC 28304 | 2018-06-25 |
| 1861986267 | Pediatric After Hours Care of Fayetteville | Pediatrics | 556 Sandhurst Drive, Fayetteville, NC 28304 | 2018-06-19 |
| 1700386133 | Good Night Medical of Ohio, LLC | Durable Medical Equipment & Medical Supplies | 405 Owen Dr Ste 202, Fayetteville, NC 28304 | 2018-02-12 |
| 1003321365 | Valleygate Dental Surgery Center of Fayetteville, LLC | Dentist | 2038 Litho Place, Fayetteville, NC 28304 | 2017-12-08 |
| 1871004663 | The Salt Project | Marriage & Family Therapist | 1611-b Owen Dr., Fayetteville, NC 28304 | 2017-10-19 |
| Find all providers in zip 28304 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275001851 | Cquentia Arkansas Lab LLC | Clinical Medical Laboratory | 112 W Center St Ste 504, Fayetteville, AR 72701-6073 | 2018-11-13 |
| 1962899989 | Ancillary Innovations | Clinical Medical Laboratory | 1792 E Joyce Blvd Ste 3, Fayetteville, AR 72703-5255 | 2015-04-16 |
| 1932404274 | Kaiser Permanente | Clinical Medical Laboratory | 101 Banks Sta, Fayetteville, GA 30214-7507 | 2011-01-18 |
| 1124646013 | Namida Lab Inc. | Clinical Medical Laboratory | 1905 E Mission Blvd Ste 6, Fayetteville, AR 72703-3129 | 2020-07-08 |
| 1053850206 | Bluewest/lab LLC | Clinical Medical Laboratory | 1076 Stamper Rd, Fayetteville, NC 28303-4191 | 2017-02-21 |
| 1356889950 | Cumberland County Health System Inc | Clinical Medical Laboratory | 1638 Owen Dr, Fayetteville, NC 28304-3424 | 2017-02-03 |
| 1336517507 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 1307 Avon St, Fayetteville, NC 28304-4423 | 2015-09-04 |
| 1063802718 | Carolina Outreach, LLC | Clinical Medical Laboratory | 911 Hay St, Fayetteville, NC 28305-5313 | 2015-02-03 |
| 1790184760 | Arkansas Medical Imaging Jv LLC | Clinical Medical Laboratory | 361 E Millsap Rd, Fayetteville, AR 72703-6289 | 2014-08-15 |
| 1669800165 | Lab One LLC | Clinical Medical Laboratory | 3215 N Northhills Blvd, Ste B, Fayetteville, AR 72703-4424 | 2013-10-17 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28304 |
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| 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.