Organization
SERVANT'S HEART
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINA TANNER (DIRECTOR/QP)
(336) 286-6400
Entity
Organization
Contact information
Practice address
1921 NEW GARDEN RD APT K107, GREENSBORO, NC 27410-2250
(336) 282-9025
Mailing address
532 N REGIONAL RD STE E, GREENSBORO, NC 27409-9057
(336) 286-6400
(336) 664-1212
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
MHL-041-773
NC
Other
Enumeration date
03/17/2014
Last updated
03/18/2014
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