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General NPI Number Information
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NPI Number | 1982709622
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Entity Type | Organization
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Legal Business Name | BLUE RIDGE HEALTH SERVICES
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 02/02/2012
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Provider Practice Location Address
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Address Line | 7 DUNDAS CIR STE F
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City | GREENSBORO
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State | NC
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Zip | 27407-1645
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Country | US
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Telephone | 336-292-1597
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Fax | 336-292-1161
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Provider Business Mailing Address
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Address Line | 9 FAWNWOOD CT
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City | GREENSBORO
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State | NC
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Zip | 27407-6139
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Country | US
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Telephone | 336-292-1597
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Fax | 336-292-1161
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. LUBNA SACHEDINA REECE
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Credential |
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Telephone | 336-292-1597
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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 | 3409001
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License Number State | NC
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