Lifesource Of North Carolina

LBN: Lifesource Of North Carolina
Lifesource Of North Carolina is an health care organization with primary practice located at 140 Park Ave , Bloomfield CT 06002-3207. The organization recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Allopathic & Osteopathic Physicians / Psychiatry, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Behavioral Health & Social Service Providers / Clinical is the primary health care specialty. Lifesource Of North Carolina can be contacted via phone (910) 742-9243, or through Baddour, Peggy via phone (910) 777-9165.

Contact Information

Primary practice address
140 Park Ave Bloomfield CT 06002-3207
Phone: (910) 742-9243
Fax: (888) 746-1787
Website:
Map and Directions
Authorized official contact:
Name: Baddour, Peggy
Phone: (910) 777-9165

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X
Behavioral Health & Social Service Providers / Clinical 1041C0700X
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X

Profile Details

NPI number 1972131308
LBN Legal business name Lifesource Of North Carolina
DBA Doing business as
Authorized official Baddour, Peggy
Entity Organization
Organization subpart 1 No
Enumeration date Mar 31st, 2020
Last updated Mar 26th, 2021 - about 3 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.

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