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General NPI Number Information
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NPI Number | 1558560029
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Entity Type | Organization
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Legal Business Name | ADESS RESIDENTIAL SERVICES, INC.
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Dates
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Enumeration Date | 07/15/2007
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Last Update Date | 06/23/2008
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Provider Practice Location Address
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Address Line | 605 THORNBERRY DR
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City | GREENSBORO
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State | NC
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Zip | 27455-1517
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Country | US
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Telephone | 336-545-9779
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Fax | 336-282-6911
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Provider Business Mailing Address
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Address Line | 2419 OLD TOWNE DR
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City | GREENSBORO
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State | NC
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Zip | 27455-3439
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Country | US
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Telephone | 336-545-9779
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Fax | 336-282-6911
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. JESSIE M ADAMS
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Credential |
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Telephone | 336-549-1580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | MHL-041-824
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License Number State | NC
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