Organization
BAC DEVELOPMENTAL PROGRAM INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLETTE CARRINTON (ASST DIRECTOR)
(336) 545-4473
Entity
Organization
Contact information
Practice address
2203 COLISEUM BLVD, GREENSBORO, NC 27403
(336) 323-0066
(336) 545-4473
Mailing address
4309 PENTON PL, GREENSBORO, NC 27455
(336) 545-4473
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
NC
Other
Enumeration date
09/04/2017
Last updated
09/04/2017
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