| Lifesource Of North Carolina | |
|
505 Robert Blvd Slidell LA 70458-1645 | |
| (910) 742-9243 | |
| (888) 746-1787 |
| Full Name | Lifesource Of North Carolina |
|---|---|
| Speciality | Social Worker |
| Location | 505 Robert Blvd, Slidell, Louisiana |
| Authorized Official Name and Position | Peggy L Baddour (PRESIDENT) |
| Authorized Official Contact | 9107779165 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifesource Of North Carolina Po Box 538622 Atlanta GA 30353-8622 Ph: (910) 535-1211 | Lifesource Of North Carolina 505 Robert Blvd Slidell LA 70458-1645 Ph: (910) 742-9243 |
| NPI Number | 1497378848 |
|---|---|
| Provider Enumeration Date | 05/20/2020 |
| Last Update Date | 03/25/2021 |
| Certification Date | 03/25/2021 |
| Medicare PECOS PAC ID | 7416132428 |
|---|---|
| Medicare Enrollment ID | O20200604002593 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497378848 | NPI | - | NPPES |
| Provider Name | Melanie Lepine |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710384797 PECOS PAC ID: 9638590326 Enrollment ID: I20200604002630 |
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