Healthcare Provider Details

I. General information

NPI: 1669607974
Provider Name (Legal Business Name): HANDS TO HANDS REHABILITATION CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2009
Last Update Date: 05/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 S MARSHALL ST SUITE 230
WINSTON SALEM NC
27101-5852
US

IV. Provider business mailing address

1001 S MARSHALL ST BOX 123
WINSTON SALEM NC
27101-5852
US

V. Phone/Fax

Practice location:
  • Phone: 336-847-7688
  • Fax:
Mailing address:
  • Phone: 336-847-7688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. DAYA PATTON
Title or Position: DIRECTOR
Credential: MA, QMHP
Phone: 336-847-7688