| NPI | 1790129740 |
|---|---|
| Other Name | LIFESPAN BEHAVIORAL & CONSULTATION SERVICES |
| Entity Type | Organization |
| Authorized Contact | SHARONDA FERGUSON Bcba/Clinical Director 910-493-3999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: 1-12-12589) |
| Additional Taxonomies | 251S00000X (Licence: NC 1-12-12589) |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2014-04-07 |