Provider Demographics
NPI:1144393067
Name:ESELLE LINDSEY
Entity Type:Organization
Organization Name:ESELLE LINDSEY
Other - Org Name:SEQUOIA RESIDENTIAL FACILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ESTELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDSEY
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:919-775-5850
Mailing Address - Street 1:308 MCIVER ST
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-4442
Mailing Address - Country:US
Mailing Address - Phone:919-775-5850
Mailing Address - Fax:919-718-9596
Practice Address - Street 1:308 MCIVER ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-4442
Practice Address - Country:US
Practice Address - Phone:919-775-5850
Practice Address - Fax:919-718-9596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-053-047322D00000X
323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children