| Blue Group Home Llc | |
|
2722 N Church St Ste D Greensboro NC 27405-3661 | |
| (336) 456-2370 | |
| (336) 763-5065 |
| Full Name | Blue Group Home Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2722 N Church St Ste D, Greensboro, North Carolina |
| Authorized Official Name and Position | Tina R Mebane (OWNER) |
| Authorized Official Contact | 3364562370 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Group Home Llc Po Box 5016 Greensboro NC 27435-0016 Ph: (336) 456-2370 | Blue Group Home Llc 2722 N Church St Ste D Greensboro NC 27405-3661 Ph: (336) 456-2370 |
| NPI Number | 1750104246 |
|---|---|
| Provider Enumeration Date | 11/04/2024 |
| Last Update Date | 11/04/2024 |
| Certification Date | 11/04/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750104246 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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