Provider Demographics
NPI:1255488359
Name:RALPH SCOTT LIFESERVICES INC
Entity Type:Organization
Organization Name:RALPH SCOTT LIFESERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:EWING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-227-1011
Mailing Address - Street 1:408 W TRADE STREET
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27217-2400
Mailing Address - Country:US
Mailing Address - Phone:336-227-1011
Mailing Address - Fax:336-570-2855
Practice Address - Street 1:408 W TRADE STREET
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27217-2400
Practice Address - Country:US
Practice Address - Phone:336-227-1011
Practice Address - Fax:336-570-2855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8300835Medicaid