Organization
CLEGAIL PROFESSIONAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLEMENT SOWA (MEMBER)
(336) 825-7223
Entity
Organization
Contact information
Practice address
711 ASKEW ST, BURLINGTON, NC 27215-2201
(336) 825-7223
Mailing address
5635 HORNADAY RD, UNIT D, GREENSBORO, NC 27409-2941
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/05/2013
Last updated
11/05/2013
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