Provider Demographics
NPI:1427369024
Name:THE LORD'S PLACE
Entity Type:Organization
Organization Name:THE LORD'S PLACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:STANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-494-0125
Mailing Address - Street 1:2808 N AUSTRALIAN AVE
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-4592
Mailing Address - Country:US
Mailing Address - Phone:561-494-0125
Mailing Address - Fax:561-494-2922
Practice Address - Street 1:2808 N AUSTRALIAN AVE
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-4592
Practice Address - Country:US
Practice Address - Phone:561-494-0125
Practice Address - Fax:561-494-2922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-29
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management