Provider Demographics
NPI:1053563650
Name:LIFE LINKS COMMUNITY INTERVENTION AGENCY
Entity type:Organization
Organization Name:LIFE LINKS COMMUNITY INTERVENTION AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:FOX
Authorized Official - Last Name:DARDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-747-7801
Mailing Address - Street 1:101 W GREENE ST
Mailing Address - Street 2:
Mailing Address - City:SNOW HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28580-1431
Mailing Address - Country:US
Mailing Address - Phone:252-747-7801
Mailing Address - Fax:252-747-7802
Practice Address - Street 1:101 W GREENE ST
Practice Address - Street 2:
Practice Address - City:SNOW HILL
Practice Address - State:NC
Practice Address - Zip Code:28580-1431
Practice Address - Country:US
Practice Address - Phone:252-747-7801
Practice Address - Fax:252-747-7802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-15
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health