Healthcare Provider Details

I. General information

NPI: 1306701925
Provider Name (Legal Business Name): ADAPTIVE LIVING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 E MONTCASTLE DR APT A
GREENSBORO NC
27406-5325
US

IV. Provider business mailing address

406 E MONTCASTLE DR APT A
GREENSBORO NC
27406-5325
US

V. Phone/Fax

Practice location:
  • Phone: 678-913-4545
  • Fax:
Mailing address:
  • Phone: 678-913-4545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ROBBIE JOHNSON
Title or Position: OWNER, DIRECTOR
Credential:
Phone: 678-913-4545