Healthcare Provider Details

I. General information

NPI: 1902102221
Provider Name (Legal Business Name): PACE OF GUILFORD AND ROCKINGHAM COUNTIES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2011
Last Update Date: 02/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1471 E CONE BLVD
GREENSBORO NC
27405-4533
US

IV. Provider business mailing address

1471 E CONE BLVD
GREENSBORO NC
27405-4533
US

V. Phone/Fax

Practice location:
  • Phone: 336-550-4040
  • Fax: 336-550-4044
Mailing address:
  • Phone: 336-550-4040
  • Fax: 336-550-4044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. STEPHEN P FLEMING
Title or Position: BOARD CHAIR
Credential:
Phone: 336-545-5400