Organization
HEALTHCARE RESOURCES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLEOPHAS STEWART (DIRECTOR)
(336) 299-5100
Entity
Organization
Contact information
Practice address
5500 ADAMS FARM LN, SUITE 206, GREENSBORO, NC 27407-7063
(336) 299-5100
(336) 299-5111
Mailing address
PO BOX 7853, GREENSBORO, NC 27417-0853
(336) 299-5100
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
Other
Enumeration date
11/27/2007
Last updated
11/27/2007
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