Organization
BLUE GROUP HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TINA R MEBANE (OWNER)
(336) 456-2370
Entity
Organization
Contact information
Practice address
2722 N CHURCH ST STE D, GREENSBORO, NC 27405-3661
(336) 456-2370
(336) 763-5065
Mailing address
PO BOX 5016, GREENSBORO, NC 27435-0016
(336) 456-2370
(336) 763-5065
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
11/04/2024
Last updated
11/04/2024
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