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General NPI Number Information
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NPI Number | 1093774614
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Entity Type | Organization
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Legal Business Name | AUTHORACARE COLLECTIVE
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Dates
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Enumeration Date | 03/22/2006
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Last Update Date | 05/06/2020
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Provider Practice Location Address
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Address Line | 2500 SUMMIT AVE
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City | GREENSBORO
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State | NC
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Zip | 27405-4522
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Country | US
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Telephone | 336-621-2500
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Fax | 336-621-4516
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Provider Business Mailing Address
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Address Line | 2500 SUMMIT AVE
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City | GREENSBORO
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State | NC
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Zip | 27405-4522
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Country | US
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Telephone | 336-621-2500
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Fax | 336-621-4516
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Authorized Official
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Title or Position | CEO
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Name | MRS. KRISTEN WITHER YNTEMA
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Credential | MBA, MHSA
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Telephone | 336-621-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HC0374
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | HC0374
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License Number State | NC
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