Organization
MENTORING FOR CHANGE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DALTON STEPHON KORNEGAY (PHD)
(252) 714-2145
Entity
Organization
Contact information
Practice address
211 W 14TH ST, SUITE D, GREENVILLE, NC 27834-4081
(252) 695-2004
(252) 695-2005
Mailing address
1206 EVANS ST, GREENVILLE, NC 27834-4102
(252) 695-2004
(252) 695-2005
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
05/10/2010
Last updated
05/13/2010
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