NPI 1750692620

Life St. Joseph of the Pines, INC.

Organisation PACE Provider Organization Fayetteville, NC

Practice location

Address: 4900 Raeford Rd, Fayetteville, NC 28304-3142
Phone: (910) 483-4911

Authorised official

Name: Robert Lawrence Dickson
Title: Executive Director
Phone: (910) 429-7255

Registered specialties

PACE Provider Organization Primary

Agencies Taxonomy 251T00000X Licence PENDING (NC)

Other Program of All-Inclusive Care for the Elderly (PACE) Provider Organization providers in North Carolina →

Registry record

NPI: 1750692620
Entity type: Organization
NPI issued: 25 Jun 2010
Record last updated: 8 Feb 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.