Organization
NC MENTOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DANIELLE YVONNE FAY LCSWA (TEAM LEAD)
(336) 856-1140
Entity
Organization
Contact information
Practice address
7 OAK BRANCH DR STE C, GREENSBORO, NC 27407-2392
(336) 856-1140
(336) 856-1128
Mailing address
7 OAK BRANCH DR STE C, GREENSBORO, NC 27407-2392
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
P005841
NC
Other
Enumeration date
12/11/2012
Last updated
12/11/2012
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