MEDICARE: THE GUILFORD COUNTY RESOURCE AND REFERRAL CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1184851438
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE GUILFORD COUNTY RESOURCE AND REFERRAL CENTER

Provider Business Mailing Address
First Line	:	725 W MAIN ST
Second Line	:	SUITE B
City	:	JAMESTOWN
State	:	NC
Zip	:	27282-7506
Country	:	US
Telephone Number	:	336-255-1148
Fax Number	:	336-454-9009

Provider Business Practice Location Address
First Line	:	725 W MAIN ST
Second Line	:	SUITE B
City	:	JAMESTOWN
State	:	NC
Zip	:	27282-7506
Country	:	US
Telephone Number	:	336-255-1148
Fax Number	:	336-454-9009

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. SHAWANA DENISE TORRENCE
Credential	:
Telephone Number	:	336-255-1148

Provider Enumeration Date	:	06/14/2009
Last Update Date	:	06/14/2009

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