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General NPI Number Information
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NPI Number | 1487897468
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Entity Type | Organization
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Legal Business Name | BLACK AND ASSOCIATES GLOBAL INC
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Dates
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Enumeration Date | 04/07/2009
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Last Update Date | 04/13/2009
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Provider Practice Location Address
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Address Line | 1502 CLOVERDALE ST.,
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City | HIGH POINT
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State | NC
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Zip | 27260-4412
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Country | US
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Telephone | 336-889-3021
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Fax | 336-454-0191
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Provider Business Mailing Address
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Address Line | 102 BURROWS RD.,
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City | JAMESTOWN
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State | NC
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Zip | 27282-8400
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Country | US
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Telephone | 336-987-0572
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Fax | 336-454-0191
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. ELLEN R. BLACK
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Credential |
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Telephone | 336-987-0572
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | 041-898
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License Number State | NC
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