Organization
ELI GROUP HOME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL NTIBREY FNP (CEO)
(336) 772-0568
Entity
Organization
Contact information
Practice address
5699 APPLETON RD, GREENSBORO, NC 27405-9548
(336) 772-0568
Mailing address
5699 APPLETON RD, GREENSBORO, NC 27405-9548
(336) 772-0568
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
IRS
NC
Enumeration date
01/18/2021
Last updated
01/18/2021
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