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General NPI Number Information
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NPI Number | 1457224073
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Entity Type | Individual
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Provider Name | LATOYA CELESTE TATE
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Gender | Female
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Dates
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Enumeration Date | 09/29/2025
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 900 BRUSHY FORK DR
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City | GREENSBORO
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State | NC
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Zip | 27406-8059
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Country | US
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Telephone | 336-303-6922
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Fax |
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Provider Business Mailing Address
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Address Line | 5103 MALLISON WAY
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City | MC LEANSVILLE
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State | NC
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Zip | 27301-9004
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Country | US
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Telephone | 336-303-6922
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | NC
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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State | NC
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