Provider Demographics
NPI:1346576436
Name:LE BONHEUR GROUP INC
Entity Type:Organization
Organization Name:LE BONHEUR GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:CROSSWELL
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:704-345-8861
Mailing Address - Street 1:10223 UNIVERSITY CITY BLVD
Mailing Address - Street 2:SUITE B-116
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-3782
Mailing Address - Country:US
Mailing Address - Phone:704-345-8861
Mailing Address - Fax:
Practice Address - Street 1:10223 UNIVERSITY CITY BLVD
Practice Address - Street 2:SUITE B-116
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28213-3782
Practice Address - Country:US
Practice Address - Phone:704-345-8861
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-23
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC25568207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty