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General NPI Number Information
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NPI Number | 1023214731
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Entity Type | Organization
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Legal Business Name | CENTRAL STATE OF THE CAROLINAS, INC.
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Dates
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Enumeration Date | 06/21/2007
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Last Update Date | 09/13/2007
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Provider Practice Location Address
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Address Line | 122 N ELM ST SUITE 800
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City | GREENSBORO
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State | NC
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Zip | 27401-2878
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Country | US
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Telephone | 336-370-1691
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Fax | 336-370-4758
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Provider Business Mailing Address
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Address Line | 122 N ELM ST SUITE 800
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City | GREENSBORO
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State | NC
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Zip | 27401-2878
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Country | US
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Telephone | 336-370-1691
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Fax | 336-370-4758
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Authorized Official
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Title or Position | EXEC. DIRECTOR
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Name | MRS. DEBRA A MELOY IX
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Credential |
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Telephone | 336-370-1691
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State | NC
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