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Organization

THE BAKERS HOUSE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. TABETHA TENIKA BAKER (EXECUTIVE DIRECTOR)
(336) 274-6874
Entity
Organization

Contact information

Practice address
1004 RICHARDSON ST, GREENSBORO, NC 27403-2951
(336) 274-6874
Mailing address
1004 RICHARDSON ST, GREENSBORO, NC 27403-2951
(336) 274-6874

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
MHL-041-744
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
041-744
MHL-LICENSE NUMBER
NC
05
7805161
NC
05
8301455
NC
Enumeration date
01/25/2007
Last updated
08/22/2020
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