Provider Demographics
NPI:1649335027
Name:LE CHRIS ADULT DAY CARE OF ROCKY MOUNT, INC.
Entity type:Organization
Organization Name:LE CHRIS ADULT DAY CARE OF ROCKY MOUNT, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:H
Authorized Official - Last Name:SCHWARZ
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:252-671-6371
Mailing Address - Street 1:1822 S GLENBURNIE RD STE 352
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-5261
Mailing Address - Country:US
Mailing Address - Phone:125-267-1637
Mailing Address - Fax:252-451-1333
Practice Address - Street 1:130 JONES RD
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-2349
Practice Address - Country:US
Practice Address - Phone:252-451-1333
Practice Address - Fax:252-451-1333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
NCMHL-064-074251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8300275Medicaid
NC8300275GMedicaid
NC8300275SMedicaid
NC8300275BMedicaid
NC8300275HMedicaid