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NPI Code Detail

MEDICARE: 1ELEVEN LLC

MEDICARE: 1ELEVEN LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center
2251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1114874104
Entity Type Code : Organization
Provider Name (Legal Business Name) : 1ELEVEN LLC
Provider Business Mailing Address
First Line : 2301 N CHURCH ST
Second Line :
City : GREENSBORO
State : NC
Zip : 27405-4309
Country : US
Telephone Number : 800-784-6845
Fax Number : 781-394-2662
Provider Business Practice Location Address
First Line : 2301 N CHURCH ST
Second Line :
City : GREENSBORO
State : NC
Zip : 27405-4309
Country : US
Telephone Number : 800-784-6845
Fax Number : 781-394-2662
Authorized Official
Title or Position : DIRECTOR OF BILLING
Name : SAM DAVID STEELE
Credential :
Telephone Number : 781-366-3953
Provider Enumeration Date : 03/11/2026
Last Update Date : 03/11/2026

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Directions to “1ELEVEN LLC ” Practice Location

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