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NPI Code Detail

MEDICARE: BLAIR KAHZAN CENTER

MEDICARE: BLAIR KAHZAN CENTER
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
1311ZA0620XAdult Care Home FacilityFCL-041-069NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144358854
Entity Type Code : Organization
Provider Name (Legal Business Name) : BLAIR KAHZAN CENTER
Provider Business Mailing Address
First Line : 5231 HOPKINS RD
Second Line :
City : BROWNS SUMMIT
State : NC
Zip : 27214-9448
Country : US
Telephone Number : 336-656-4970
Fax Number : 336-272-6359
Provider Business Practice Location Address
First Line : 2007 BLAIR KAHZAN DR
Second Line :
City : GREENSBORO
State : NC
Zip : 27405-4380
Country : US
Telephone Number : 336-656-4970
Fax Number : 336-272-6359
Authorized Official
Title or Position : OWNER
Name : GLENDA TODD LIGGINS
Credential :
Telephone Number : 336-275-7328
Provider Enumeration Date : 03/02/2007
Last Update Date : 07/14/2016

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Directions to “BLAIR KAHZAN CENTER ” Practice Location

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