Organization
PTA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HRACHEL AYUN (PTA)
(336) 609-1832
Entity
Organization
Contact information
Practice address
1900 SHELDON ROAD, GREENSBORO, NC 27405
(336) 609-1832
Mailing address
1900 SHELDON RD, GREENSBORO, NC 27405-1645
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
2251500000X
NC
Other
Enumeration date
12/23/2015
Last updated
12/23/2015
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