| New Lite Living Choices | |
|
349 Copperfield Blvd Ne Suite 5 Concord NC 28025-2408 | |
| (704) 771-0456 | |
| Not Available |
| Full Name | New Lite Living Choices |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 349 Copperfield Blvd Ne, Concord, North Carolina |
| Authorized Official Name and Position | Tracy Gibbs (ADMINISTRATOR) |
| Authorized Official Contact | 7047710456 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| New Lite Living Choices Po Box 1310 Suite 5 Concord NC 28026-1310 Ph: (704) 771-0456 | New Lite Living Choices 349 Copperfield Blvd Ne Suite 5 Concord NC 28025-2408 Ph: (704) 771-0456 |
| NPI Number | 1255507992 |
|---|---|
| Provider Enumeration Date | 05/02/2008 |
| Last Update Date | 03/04/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255507992 | NPI | - | NPPES |
| 8300407 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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