Provider Demographics
NPI:1407276710
Name:LIFTDAY ACTIVITY CENTER
Entity Type:Organization
Organization Name:LIFTDAY ACTIVITY CENTER
Other - Org Name:LIFT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRENDEX
Authorized Official - Middle Name:RENEA
Authorized Official - Last Name:MEEKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-390-4429
Mailing Address - Street 1:313 W SYCAMORE ST
Mailing Address - Street 2:
Mailing Address - City:ZEBULON
Mailing Address - State:NC
Mailing Address - Zip Code:27597-2530
Mailing Address - Country:US
Mailing Address - Phone:919-569-9566
Mailing Address - Fax:919-569-0269
Practice Address - Street 1:313 W SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:ZEBULON
Practice Address - State:NC
Practice Address - Zip Code:27597-2530
Practice Address - Country:US
Practice Address - Phone:919-569-9566
Practice Address - Fax:919-569-0269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-25
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-092-742251T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization