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6184 Lake Brandt Rd Greensboro NC 27455-8234 | |
| (336) 996-7556 | |
| (336) 996-7602 |
| Full Name | |
|---|---|
| Speciality | Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities |
| Location | 6184 Lake Brandt Rd, Greensboro, North Carolina |
| Authorized Official Name and Position | Jennifer D Lozano (DIRECTOR) |
| Authorized Official Contact | 4043642900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1819 Peachtree Rd Ne Ste 450 Atlanta GA 30309-1848 Ph: (404) 364-2900 | 6184 Lake Brandt Rd Greensboro NC 27455-8234 Ph: (336) 996-7556 |
| NPI Number | 1316073406 |
|---|---|
| Provider Enumeration Date | 02/26/2007 |
| Last Update Date | 09/24/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316073406 | NPI | - | NPPES |
| 7804550 | Medicaid | NC |
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