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General NPI Number Information
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NPI Number | 1326794652
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Entity Type | Organization
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Legal Business Name | THE WELL OF HOPE BEHAVIORAL SERVICES
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Dates
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Enumeration Date | 02/24/2022
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Last Update Date | 01/17/2024
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Provider Practice Location Address
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Address Line | 5 CENTERVIEW DR STE 158
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City | GREENSBORO
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State | NC
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Zip | 27407-3709
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Country | US
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Telephone | 919-599-7751
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Fax |
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Provider Business Mailing Address
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Address Line | 5 CENTERVIEW DR STE 158
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City | GREENSBORO
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State | NC
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Zip | 27407-3709
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Country | US
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Telephone | 919-599-7751
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Fax |
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Authorized Official
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Title or Position | OWNER/SERVICE PROVIDER
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Name | BEVERLEY DIANE GRAY
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Credential | LCMHC
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Telephone | 919-599-7751
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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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