MEDICARE: ADULT CENTER FOR ENRICHMENT, INC.

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
1	261QA0600X	Adult Day Care Clinic/Center

Other Identifiers

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

General Provider Information

NPI Number	:	1477683720
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADULT CENTER FOR ENRICHMENT, INC.

Provider Business Mailing Address
First Line	:	PO BOX 13048
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27415-3048
Country	:	US
Telephone Number	:	336-274-3559
Fax Number	:	336-373-0926

Provider Business Practice Location Address
First Line	:	11 OAK BRANCH DR
Second Line	:	SUITE B
City	:	GREENSBORO
State	:	NC
Zip	:	27407-2453
Country	:	US
Telephone Number	:	336-274-3559
Fax Number	:	336-373-0926

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. ALVA S. CROMARTIE
Credential	:
Telephone Number	:	336-274-3559

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	09/28/2012

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