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NPI Code Detail

MEDICARE: RILEY HALL

MEDICARE: RILEY HALL
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1417899428
Entity Type Code : Individual
Provider Name (Legal Business Name) : RILEY HALL
Provider Business Mailing Address
First Line : 905 FRIEDBERG CHURCH RD
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27127-9803
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 905 FRIEDBERG CHURCH RD
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27127-9803
Country : US
Telephone Number : 336-251-1180
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2026
Last Update Date : 04/08/2026

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Directions to “ RILEY HALL ” Practice Location

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