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General NPI Number Information
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NPI Number | 1124266937
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Entity Type | Organization
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Legal Business Name | G.W. STRONG HOUSE, LLC
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Dates
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Enumeration Date | 02/02/2009
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Last Update Date | 02/02/2009
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Provider Practice Location Address
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Address Line | 503 LOWDERMILK ST
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City | GREENSBORO
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State | NC
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Zip | 27401-4440
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Country | US
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Telephone | 336-963-0477
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Fax | 336-498-1179
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Provider Business Mailing Address
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Address Line | 176 MORNINGSIDE RD
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City | RANDLEMAN
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State | NC
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Zip | 27317-7561
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Country | US
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Telephone | 336-963-0477
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Fax | 336-498-1179
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Authorized Official
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Title or Position | OWNER
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Name | W RODNEY FOX
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Credential |
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Telephone | 336-963-0477
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | MHL041889
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License Number State | NC
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