Organization
JMJ ENTERPRISE, LLC
Active
Other names
Fresh Start Home for Children
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRACI DERONN MARTIN (OWNER / EXECUTIVE DIRECTOR)
(336) 271-6982
Entity
Organization
Contact information
Practice address
2020 TEXTILE DR, GREENSBORO, NC 27405-5857
(336) 271-6982
(336) 271-6982
Mailing address
2020 TEXTILE DR, GREENSBORO, NC 27405-5857
(336) 271-6982
(336) 271-6982
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
MHL-041-857
NC
Other
Enumeration date
07/28/2009
Last updated
02/16/2010
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