Provider Demographics
NPI:1700187242
Name:ESTEEM FAMILY LIFE CENTER LLC
Entity Type:Organization
Organization Name:ESTEEM FAMILY LIFE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:COLEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCAGLIARINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-334-1432
Mailing Address - Street 1:10614 ANDIRON DR
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-7208
Mailing Address - Country:US
Mailing Address - Phone:704-942-0999
Mailing Address - Fax:704-334-1433
Practice Address - Street 1:1219 ROCKINGHAM RD
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-4983
Practice Address - Country:US
Practice Address - Phone:910-997-4926
Practice Address - Fax:910-997-4927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-16
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management