Organization
AFTER GATEWAY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN W MCMANUS QDDP (ADMINISTRATIVE DIRECTOR)
(336) 379-7670
Entity
Organization
Contact information
Practice address
501 S MENDENHALL ST, GREENSBORO, NC 27403-2514
(336) 379-7670
(336) 379-7317
Mailing address
501 S MENDENHALL ST, GREENSBORO, NC 27403-2514
(336) 379-7670
(336) 379-7317
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3409398
—
NC
Enumeration date
04/04/2007
Last updated
08/22/2020
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