Healthcare Provider Details
I. General information
NPI: 1386388148
Provider Name (Legal Business Name): INFINITY TREATMENT SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/26/2022
Last Update Date: 04/26/2022
Certification Date: 04/26/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
708 BLUE MOON CT
GREENSBORO NC
27455-9349
US
IV. Provider business mailing address
708 BLUE MOON CT
GREENSBORO NC
27455-9349
US
V. Phone/Fax
- Phone: 336-471-4882
- Fax:
- Phone: 336-471-4882
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QA0505X |
| Taxonomy | Adult Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
WARREN
TORRENCE
Title or Position: CEO
Credential:
Phone: 336-471-4882