Provider Demographics
NPI:1104006444
Name:ESTELLE LINDSEY/DBA SEQUOIA RESIDENTIAL FACILITY 2
Entity Type:Organization
Organization Name:ESTELLE LINDSEY/DBA SEQUOIA RESIDENTIAL FACILITY 2
Other - Org Name:SEQUOIA RESIDENTIAL FACILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ESTELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDSEY
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:919-742-2893
Mailing Address - Street 1:1519 DUET DR
Mailing Address - Street 2:
Mailing Address - City:SILER CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27344-1603
Mailing Address - Country:US
Mailing Address - Phone:919-742-2893
Mailing Address - Fax:919-718-9596
Practice Address - Street 1:1519 DUET DR
Practice Address - Street 2:
Practice Address - City:SILER CITY
Practice Address - State:NC
Practice Address - Zip Code:27344-1603
Practice Address - Country:US
Practice Address - Phone:919-742-2893
Practice Address - Fax:919-718-9596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-03
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC019045322D00000X, 323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility