Family Legacy Mental Health Services Inc
LBN: Family Legacy Mental Health Services Inc
Family Legacy Mental Health Services Inc is an health care organization with primary practice located at 1007 Broad St , Durham NC 27705-4143. The organization recently has 8 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Counseling, Behavioral Health & Social Service Providers / Marriage & Family Therapist, Allopathic & Osteopathic Physicians / Adolescent Medicine, Agencies / Case Management, Agencies / Community/Behavioral Health, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Agencies / Community/Behavioral Health is the primary health care specialty.
Family Legacy Mental Health Services Inc can be contacted via phone (919) 834-2000, or through Stacey, Lisa Dyan via phone (919) 834-2000.
Contact Information
Primary practice address
1007 Broad St
Durham NC 27705-4143
Phone: (919) 834-2000
Fax: (919) 834-2001
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 6102775 | North Carolina |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 6107485 | North Carolina |
| Behavioral Health & Social Service Providers / Counseling | 103TC1900X | 6001168 | North Carolina |
| Behavioral Health & Social Service Providers / Marriage & Family Therapist | 106H00000X | 6105171 | North Carolina |
| Allopathic & Osteopathic Physicians / Adolescent Medicine | 2080A0000X | 9300596 | North Carolina |
| Agencies / Case Management | 251B00000X | ||
| Agencies / Community/Behavioral Health | 251S00000X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X |
Profile Details
| NPI number | 1932371655 |
|---|---|
| LBN Legal business name | Family Legacy Mental Health Services Inc |
| DBA Doing business as | |
| Authorized official | Stacey, Lisa Dyan B.S. Q.P |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Apr 2nd, 2008 |
| Last updated | Jun 18th, 2014 - about 11 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932371655 | NPPES |
| North Carolina | MEDICAID | 8302925 | |
| North Carolina | MEDICAID | 8302411 | |
| North Carolina | MEDICAID | 5913953 | |
| North Carolina | MEDICAID | 6006506 |
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