Provider Demographics
NPI:1659481646
Name:LAWSONS FAMILY CARE 2
Entity Type:Organization
Organization Name:LAWSONS FAMILY CARE 2
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:WILLIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:LAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-342-4953
Mailing Address - Street 1:704 WILLOW ST
Mailing Address - Street 2:P.O. BOX 1443
Mailing Address - City:REIDSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27320-3043
Mailing Address - Country:US
Mailing Address - Phone:336-342-4953
Mailing Address - Fax:
Practice Address - Street 1:704 WILLOW ST
Practice Address - Street 2:
Practice Address - City:REIDSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27320-3043
Practice Address - Country:US
Practice Address - Phone:336-342-4953
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL-079-011310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7801025OtherEDS NUMBER