Organization
A PLACE FOR T.J. HEALTH CARE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LETITHIA PELHAM PARKER (DIRECTOR)
(336) 505-0384
Entity
Organization
Contact information
Practice address
5001 HEATHRIDGE TER, GREENSBORO, NC 27410-8419
(336) 505-0384
(336) 505-0384
Mailing address
PO BOX 39732, GREENSBORO, NC 27438-9732
(336) 505-0384
(336) 505-0384
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
MHL04177
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7805511
—
NC
Enumeration date
03/15/2007
Last updated
08/22/2020
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