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General NPI Number Information
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NPI Number | 1255539235
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Entity Type | Organization
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Legal Business Name | CHILDRENS HOME SOCIETY OF NC
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Dates
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Enumeration Date | 07/11/2007
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | 604 MEADOW ST
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City | GREENSBORO
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State | NC
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Zip | 27405-6600
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Country | US
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Telephone | 336-274-1538
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Fax | 336-274-7347
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Provider Business Mailing Address
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Address Line | PO BOX 14608
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City | GREENSBORO
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State | NC
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Zip | 27415-4608
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Country | US
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Telephone | 336-274-1538
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Fax | 336-379-5835
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. KENNETH E TUTTEROW
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Credential |
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Telephone | 336-274-1538
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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 | 200501663
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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