Organization
BLACK & ASSOCIATES GLOBAL INC
Active
Other names
OUR HOME - AUNT ZOLA'S
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELLEN ROGERS BLACK OWNER (ADMINISTRATOR)
(336) 987-0572
Entity
Organization
Contact information
Practice address
408 ANDREW ST, GREENSBORO, NC 27406-1515
(336) 271-2004
(336) 454-0191
Mailing address
102 BURROWS RD, JAMESTOWN, NC 27282-8400
(336) 987-0572
(336) 454-0191
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
MHL 041-781
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603997
—
NC
Enumeration date
03/07/2007
Last updated
07/07/2008
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