Provider Demographics
NPI:1598809691
Name:LEE COUNTY
Entity Type:Organization
Organization Name:LEE COUNTY
Other - Org Name:LEE COUNTY HEALTH DEPARTMENT-HIV CASE MGMT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTH DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:HANES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-718-4640
Mailing Address - Street 1:106 HILLCREST DR
Mailing Address - Street 2:PO BOX 1528
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-4021
Mailing Address - Country:US
Mailing Address - Phone:919-718-4640
Mailing Address - Fax:
Practice Address - Street 1:106 HILLCREST DR
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-4021
Practice Address - Country:US
Practice Address - Phone:919-718-4640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8700297Medicaid
NC8700297Medicaid