Organization
OUTWARD BOUND ONE, LLC
Active
Other names
Outward Bound Community Services
Organization subpart
No
Provider details
NPI number
Authorized official
TRISHONDA PATRICK (EXECUTIVE DIRECTOR)
(336) 553-9898
Entity
Organization
Contact information
Practice address
620 GUILFORD COLLEGE RD, STE G, GREENSBORO, NC 27409-2292
(336) 553-9898
(336) 447-1955
Mailing address
620 GUILFORD COLLEGE RD, STE G, GREENSBORO, NC 27409-2292
(336) 553-9898
(336) 447-1955
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
NC
253Z00000X
In Home Supportive Care Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/28/2008
Last updated
06/17/2016
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