Provider Demographics
NPI:1255874244
Name:LIFEBRITE HOSPITAL GROUP OF STOKES, LLC
Entity type:Organization
Organization Name:LIFEBRITE HOSPITAL GROUP OF STOKES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FLETCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-593-5311
Mailing Address - Street 1:1570 NC 8 AND 89 HWY N
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:NC
Mailing Address - Zip Code:27016-7360
Mailing Address - Country:US
Mailing Address - Phone:336-593-5311
Mailing Address - Fax:336-593-5350
Practice Address - Street 1:1570 NC 8 AND 89 HWY N
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:NC
Practice Address - Zip Code:27016-7360
Practice Address - Country:US
Practice Address - Phone:336-593-5311
Practice Address - Fax:336-593-5350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-23
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
No282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCH0165OtherHOSPITAL LICENSURE
NC34M317OtherPTAN