Organization
LOVING RECONNECTIONS BEHAVIORAL HEALTH PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN VINCENT GOVERNALE (PRACTICE MANAGER / VICE PRESIDENT)
(336) 497-5701
Entity
Organization
Contact information
Practice address
110 HEPLER ST, SUITE B, KERNERSVILLE, NC 27284-2791
(336) 497-5701
Mailing address
110 HEPLER ST, SUITE B, KERNERSVILLE, NC 27284-2791
(336) 497-5701
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
C010334
NC
Other
Enumeration date
10/07/2016
Last updated
01/23/2017
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