| Williamson Supervised Living Home | |
|
415 N Edgeworth St Suite 209 Greensboro NC 27401-2182 | |
| (336) 273-2110 | |
| (336) 273-2114 |
| Full Name | Williamson Supervised Living Home |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 415 N Edgeworth St, Greensboro, North Carolina |
| Authorized Official Name and Position | Monaca Maye Williamson (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 3362732110 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Williamson Supervised Living Home Po Box 16803 Greensboro NC 27416-0803 Ph: (336) 273-2110 | Williamson Supervised Living Home 415 N Edgeworth St Suite 209 Greensboro NC 27401-2182 Ph: (336) 273-2110 |
| NPI Number | 1669553244 |
|---|---|
| Provider Enumeration Date | 10/18/2006 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669553244 | NPI | - | NPPES |
| 8301366B | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | MHL041663 (North Carolina) | Primary |
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