NPIMap

Organization Active NPI

Family Legacy Mental Health Services, Inc

  • Community/Behavioral Health Agency
  • Burlington, NC
National Provider Identifier
1629318803
Registry record updated Jan 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
FAMILY LEGACY MENTAL HEALTH SERVICES, INC
Practice address
1205 Maple Ave
Burlington, NC 27215-6958
Phone
(336) 514-9493
NPI assigned
Feb 25, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2014

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

Authorized official

Name
Lisa Dyan Stacey, B.S. Q.P.
Title
Ceo
Phone
(919) 834-2000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1205 Maple Ave
Burlington, NC 27215-6958

Mailing address

1011 Schaub Dr
Suite 200
Raleigh, NC 27606-1862

National Provider Directory

National Provider Directory
Tax ID family
Family Legacy Mental Health Services Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1205 Maple Ave
Burlington, NC 27215
Phone (336) 514-9493

1011 Schaub Dr
Ste 200
Raleigh, NC 27606
Phone (919) 534-6511

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1361750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390780800000",
    "number": "1629318803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 SCHAUB DR",
            "address_2": "SUITE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276061862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 MAPLE AVE",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272156958",
            "telephone_number": "336-514-9493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY LEGACY MENTAL HEALTH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-25",
        "last_updated": "2014-01-27",
        "status": "A",
        "authorized_official_last_name": "STACEY",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "DYAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-834-2000",
        "authorized_official_credential": "B.S. Q.P."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2014; 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.