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Organization

A QUEST FOR CHANGE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DONNA WARREN BROCK (OWNER DIRECTOR)
(336) 473-8004
Entity
Organization

Contact information

Practice address
163 STRATFORD CT, SUITE 170, WINSTON SALEM, NC 27103-1836
(336) 724-9339
(336) 917-3046
Mailing address
163 STRATFORD CT, SUITE 170, WINSTON SALEM, NC 27103-1836
(336) 724-9339
(336) 917-3046

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8302134B
NC
05
8302134G
NC
Enumeration date
03/06/2007
Last updated
07/21/2022
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