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General NPI Number Information
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NPI Number | 1063742781
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Entity Type | Organization
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Legal Business Name | CHRIS'S REHABALITIATIVE SERVICES
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Dates
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Enumeration Date | 12/31/2009
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Last Update Date | 06/03/2015
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Provider Practice Location Address
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Address Line | 2303 W MEADOWVIEW RD SUTE 11
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City | GREENSBORO
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State | NC
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Zip | 27407-3726
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Country | US
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Telephone | 336-617-3236
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Fax | 336-617-5869
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Provider Business Mailing Address
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Address Line | PO BOX 5196
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City | GREENSBORO
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State | NC
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Zip | 27435-0196
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Country | US
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Telephone | 336-617-3236
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Fax | 336-617-5869
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Authorized Official
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Title or Position | CHEIF EXECTIVE OFFICER
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Name | EVERETTE LEVON WITHERSPOON JR.
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Credential |
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Telephone | 336-306-4815
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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