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General NPI Number Information
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NPI Number | 1770177834
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Entity Type | Organization
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Legal Business Name | JOURNEY ADULT DAY CENTER INC
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Dates
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Enumeration Date | 03/01/2021
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Last Update Date | 12/22/2023
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Provider Practice Location Address
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Address Line | 3105 YANCEYVILLE ST
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City | GREENSBORO
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State | NC
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Zip | 27405-4041
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Country | US
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Telephone | 336-617-3759
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Fax |
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Provider Business Mailing Address
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Address Line | 1451 S ELM EUGENE ST # 1211
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City | GREENSBORO
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State | NC
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Zip | 27406-2200
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/FOUNDER
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Name | FANTA DORLEY
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Credential |
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Telephone | 336-662-7284
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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Taxonomy #2
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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