| Griffith Middle Day Tx | |
|
1401 Clemmonsville Road Winston-salem NC 27127-5915 | |
| (336) 724-1412 | |
| (336) 724-1464 |
| Full Name | Griffith Middle Day Tx |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1401 Clemmonsville Road, Winston-salem, North Carolina |
| Authorized Official Name and Position | Ashley Conrad (PRESIDENT & CEO) |
| Authorized Official Contact | 3367241412 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Griffith Middle Day Tx 7670 N Point Ct Winston Salem NC 27106-3336 Ph: (336) 724-1412 | Griffith Middle Day Tx 1401 Clemmonsville Road Winston-salem NC 27127-5915 Ph: (336) 724-1412 |
| NPI Number | 1295954899 |
|---|---|
| Provider Enumeration Date | 04/24/2007 |
| Last Update Date | 12/17/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295954899 | NPI | - | NPPES |
| 8302570 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MHL-034-214 (North Carolina) | Secondary |
| 251S00000X | Community/behavioral Health | MHL-034-214 (North Carolina) | Primary |
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