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General NPI Number Information
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NPI Number | 1861634958
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Entity Type | Organization
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Legal Business Name | PUSH DEVELOPMENT CONSULTING INC
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Dates
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Enumeration Date | 04/03/2009
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Last Update Date | 04/10/2009
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Provider Practice Location Address
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Address Line | 1108 GRECADE ST
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City | GREENSBORO
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State | NC
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Zip | 27408-8729
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Country | US
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Telephone | 336-378-1612
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Fax | 336-378-1616
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Provider Business Mailing Address
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Address Line | PO BOX 39346
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City | GREENSBORO
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State | NC
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Zip | 27438-9346
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Country | US
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Telephone | 336-378-1612
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Fax | 336-378-1616
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Authorized Official
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Title or Position | CEO/FOUNDER
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Name | MS. DANA LOWE
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Credential |
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Telephone | 336-987-5608
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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 | 199106
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License Number State | NC
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