Organization
ZENITH PROVIDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VICKIE LIGHTNER HENRY (EXECUTIVE DIRECTOR)
(336) 707-4636
Entity
Organization
Contact information
Practice address
3802 BROADACRES DR, GREENSBORO, NC 27407-6502
(336) 471-7663
(336) 886-7637
Mailing address
3802 BROADACRES DR, GREENSBORO, NC 27407-6502
(336) 855-7936
(336) 855-7936
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-041-920
NC
Other
Enumeration date
08/05/2009
Last updated
08/05/2009
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