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General NPI Number Information
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NPI Number | 1255223525
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Entity Type | Organization
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Legal Business Name | NISYJA CARES LLP
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Dates
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Enumeration Date | 07/19/2025
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Last Update Date | 07/19/2025
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Provider Practice Location Address
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Address Line | 708 BLUE MOON CT
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City | GREENSBORO
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State | NC
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Zip | 27455-9349
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Country | US
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Telephone | 336-809-1039
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Fax |
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Provider Business Mailing Address
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Address Line | 708 BLUE MOON CT
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City | GREENSBORO
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State | NC
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Zip | 27455-9349
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | NICORIAH BENNETT
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Credential |
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Telephone | 336-255-3813
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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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 |
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License Number State |
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