Healthcare Provider Details

I. General information

NPI: 1871406421
Provider Name (Legal Business Name): GREATER PURPOSE LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4812 BLACK FOREST DR
GREENSBORO NC
27405-9826
US

IV. Provider business mailing address

4812 BLACK FOREST DR
GREENSBORO NC
27405-9826
US

V. Phone/Fax

Practice location:
  • Phone: 336-210-8769
  • Fax:
Mailing address:
  • Phone: 336-210-8769
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: BRANDI BULLARD
Title or Position: OWNER
Credential:
Phone: 336-210-8769