| North Carolina Children's Place, Inc | |
|
1001 S Marshall St Ste 256 Winston Salem NC 27101-5852 | |
| (336) 505-0379 | |
| Not Available |
| Full Name | North Carolina Children's Place, Inc |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 1001 S Marshall St Ste 256, Winston Salem, North Carolina |
| Authorized Official Name and Position | Alicia Y Clodfelter (VICE PRESIDENT) |
| Authorized Official Contact | 3364499775 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| North Carolina Children's Place, Inc 603 Greyrock Rd Whitsett NC 27377-9225 Ph: (336) 449-9775 | North Carolina Children's Place, Inc 1001 S Marshall St Ste 256 Winston Salem NC 27101-5852 Ph: (336) 505-0379 |
| NPI Number | 1932389475 |
|---|---|
| Provider Enumeration Date | 11/13/2007 |
| Last Update Date | 11/19/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932389475 | NPI | - | NPPES |
| 8301260 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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