Lane Home

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

MHL-051-048 Issued in NC

Legal business name

LANE HOME

Practice address

3620 Lizzie Mill Rd
Selma, NC 27576-8603

Phone

(919) 965-8407

Fax

(919) 965-8409

NPI assigned

Dec 27, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Sue Batten Lane

Title

Director

Phone

(919) 965-8407

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1578628574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 LIZZIE MILL RD",
            "city": "SELMA",
            "state": "NC",
            "postal_code": "275768603",
            "telephone_number": "919-965-8407",
            "fax_number": "919-965-8409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 LIZZIE MILL RD",
            "city": "SELMA",
            "state": "NC",
            "postal_code": "275768603",
            "telephone_number": "919-965-8407",
            "fax_number": "919-965-8409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LANE",
        "authorized_official_first_name": "SUE",
        "authorized_official_middle_name": "BATTEN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "919-965-8407",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL-051-048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603522",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Emotionally Disturbed Childrens' Residential Treatment Facility in Selma, NC
• Providers in Selma, NC by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.