Provider Demographics
NPI:1952545956
Name:LYNGRETT ENTERPRISES, INC
Entity Type:Organization
Organization Name:LYNGRETT ENTERPRISES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEVETA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-521-2246
Mailing Address - Street 1:225 S HANCOCK ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:ROCKINGHAM
Mailing Address - State:NC
Mailing Address - Zip Code:28379-3678
Mailing Address - Country:US
Mailing Address - Phone:910-261-4526
Mailing Address - Fax:252-523-7772
Practice Address - Street 1:225 S HANCOCK
Practice Address - Street 2:SUITE A
Practice Address - City:ROCKINNGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-3679
Practice Address - Country:US
Practice Address - Phone:252-523-7772
Practice Address - Fax:252-523-7772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-22
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health