Organization
BAC DEVELOPMENTAL PROGRAM INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLETTE LASHONDA CARRINGTON (OFFICE ADMINISTRATOR)
(336) 323-0066
Entity
Organization
Contact information
Practice address
2203 COLISEUM BLVD, GREENSBORO, NC 27403-3214
(336) 323-0066
Mailing address
PO BOX 16844, GREENSBORO, NC 27416-0844
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
02/16/2018
Last updated
02/16/2018
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