Organization
DIVERSIFIED CHOICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY A BARBOUR (DIRECTOR OF OPERATIONS)
(336) 926-9032
Entity
Organization
Contact information
Practice address
5032 HUTCHINS ST, WINSTON SALEM, NC 27106-2353
(336) 923-2817
Mailing address
5032 HUTCHINS ST, WINSTON SALEM, NC 27106-2353
(336) 923-2817
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3409483
—
NC
Enumeration date
03/08/2007
Last updated
07/03/2008
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