Provider Demographics
NPI:1891947560
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:
Authorized Official - Last Name:SCAGLIARINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-942-0999
Mailing Address - Street 1:1219 ROCKINGHAM RD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:ROCKINGHAM
Mailing Address - State:NC
Mailing Address - Zip Code:28379-4925
Mailing Address - Country:US
Mailing Address - Phone:910-997-4926
Mailing Address - Fax:910-997-4927
Practice Address - Street 1:1219 ROCKINGHAM RD
Practice Address - Street 2:SUITE 10
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-4925
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:2008-10-14
Last Update Date:2009-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health