Provider Demographics
NPI:1578790879
Name:LEARNING LINKS EDUCATIONAL CENTER
Entity Type:Organization
Organization Name:LEARNING LINKS EDUCATIONAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-823-6214
Mailing Address - Street 1:904 WEST BROAD STREET
Mailing Address - Street 2:SUITE D
Mailing Address - City:DUNN
Mailing Address - State:NC
Mailing Address - Zip Code:28334-4147
Mailing Address - Country:US
Mailing Address - Phone:910-821-6214
Mailing Address - Fax:
Practice Address - Street 1:904 WEST BROAD STREET
Practice Address - Street 2:SUITE D
Practice Address - City:DUNN
Practice Address - State:NC
Practice Address - Zip Code:28334-4147
Practice Address - Country:US
Practice Address - Phone:910-821-6214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-15
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCN/AMedicaid