Provider Demographics
NPI:1225242555
Name:LUTHERAN FAMILY SERVICES IN THE CAROLINAS
Entity Type:Organization
Organization Name:LUTHERAN FAMILY SERVICES IN THE CAROLINAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AR-CONTRACTS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DWIGHT
Authorized Official - Middle Name:
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-861-2850
Mailing Address - Street 1:P.O. BOX 12287
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27605-2287
Mailing Address - Country:US
Mailing Address - Phone:919-832-2620
Mailing Address - Fax:
Practice Address - Street 1:112 COX AVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27605-1817
Practice Address - Country:US
Practice Address - Phone:919-832-2620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408975Medicaid