Organization
ALL STARS GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY J MCDUFFIE (PRESIDENT CEO)
(336) 691-1772
Entity
Organization
Contact information
Practice address
2007 YANCEYVILLE ST, STE. 209 BOX 66, GREENSBORO, NC 27405-5000
(336) 691-1772
Mailing address
2007 YANCEYVILLE ST., STE. 209 BOX 66, GREENSBORO, NC 27405
(336) 691-1772
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8300889
—
NC
05
—
8300889A
—
NC
05
—
8300889B
—
NC
05
—
8300889F
—
NC
05
—
8300889G
—
NC
05
—
8300889H
—
NC
Enumeration date
02/01/2007
Last updated
08/22/2020
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