# VISION YOUTH GROUP HOME,INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Thornberry Place
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962564658
- **Authorized official:** JIMMY GUESS MSW,LCSW (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (336) 508-2203

## Contact information

- **Practice address:** 605 THORNBERRY DR, GREENSBORO, NC 27455-1517
- **Practice address phone:** (336) 282-5060
- **Mailing address:** 6107 BASCOM DR, SUMMERFIELD, NC 27358-9119
- **Mailing address phone:** (336) 508-2203

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | MHL-041-142 | NC | Yes |

## Other

- **Enumeration date:** 12/15/2006
- **Last updated:** 06/23/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 6603098 | — | NC |