Organization
ADULT DAY&RESPITE CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOANNE CAGLE MSW (EXECUTIVE DIRECTOR)
(336) 852-8338
Entity
Organization
Contact information
Practice address
3107 GROOMETOWN RD, GREENSBORO, NC 27407-5518
(336) 852-8338
(336) 852-8333
Mailing address
3107 GROOMETOWN RD, N/A, GREENSBORO, NC 27407-5518
(336) 852-8338
(336) 852-8333
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
MHL-076-099
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3409220
—
NC
Enumeration date
07/29/2011
Last updated
07/29/2011
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