Provider Demographics
NPI:1477760130
Name:LIGGINS FAMILY CARE INC
Entity Type:Organization
Organization Name:LIGGINS FAMILY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GLENDA
Authorized Official - Middle Name:T
Authorized Official - Last Name:LIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-275-7328
Mailing Address - Street 1:5231 HOPKINS RD
Mailing Address - Street 2:
Mailing Address - City:BROWNS SUMMIT
Mailing Address - State:NC
Mailing Address - Zip Code:27214-9448
Mailing Address - Country:US
Mailing Address - Phone:336-275-7328
Mailing Address - Fax:336-272-6359
Practice Address - Street 1:5231 HOPKINS RD
Practice Address - Street 2:
Practice Address - City:BROWNS SUMMIT
Practice Address - State:NC
Practice Address - Zip Code:27214-9448
Practice Address - Country:US
Practice Address - Phone:336-275-7328
Practice Address - Fax:336-272-6359
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIGGINS FAMILY CARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-16
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL-041-030320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCFCL-141-780Medicaid