| NPI | 1023234671 |
|---|---|
| Doing Business As | LIFEGATE RESIDENTIAL CARE |
| Entity Type | Organization |
| Authorized Contact | CLEOLA MAE MARTIN Program Manager 919-779-2209 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-051-157NC) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: NC MHL-051-157) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2023-09-06 |