Organization
OUTWARD BOUND ONE, LLC
Active
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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