Provider Demographics
NPI:1548407778
Name:L AND T HEALTH CARE AGENCY
Entity Type:Organization
Organization Name:L AND T HEALTH CARE AGENCY
Other - Org Name:L AND T HEALTH CARE AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:TYSON
Authorized Official - Last Name:MCLAWHORN
Authorized Official - Suffix:
Authorized Official - Credentials:HIGH SCHOOL DIPLOMA
Authorized Official - Phone:252-439-2275
Mailing Address - Street 1:2080 W ARLINGTON BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-3770
Mailing Address - Country:US
Mailing Address - Phone:252-439-2275
Mailing Address - Fax:252-439-2353
Practice Address - Street 1:1527 GREENVILLE BLVD SW
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-7026
Practice Address - Country:US
Practice Address - Phone:252-353-0711
Practice Address - Fax:252-439-2353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health