Provider Demographics
NPI:1356545206
Name:LAZARUS' HOUSE
Entity type:Organization
Organization Name:LAZARUS' HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:BRATCHER
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-724-1700
Mailing Address - Street 1:PO BOX 16401
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27115-6401
Mailing Address - Country:US
Mailing Address - Phone:336-724-1700
Mailing Address - Fax:336-703-1336
Practice Address - Street 1:4198 CHERRY ST
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27105-2536
Practice Address - Country:US
Practice Address - Phone:336-724-1700
Practice Address - Fax:336-703-1336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251B00000XAgenciesCase Management
Not Answered251E00000XAgenciesHome Health
Not Answered251K00000XAgenciesPublic Health or Welfare
Not Answered251S00000XAgenciesCommunity/Behavioral Health
Not Answered251V00000XAgenciesVoluntary or Charitable