MEDICARE: CARTERS CIRCLE OF CARE 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	251B00000X	Case Management Agency
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1720387178
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARTERS CIRCLE OF CARE INC

Provider Business Mailing Address
First Line	:	2031 MARTIN LUTHER KING JR DR
Second Line	:	STE E
City	:	GREENSBORO
State	:	NC
Zip	:	27406-3342
Country	:	US
Telephone Number	:	336-271-5888
Fax Number	:	336-271-5882

Provider Business Practice Location Address
First Line	:	2031 MARTIN LUTHER KING JR DR
Second Line	:	STE E
City	:	GREENSBORO
State	:	NC
Zip	:	27406-3342
Country	:	US
Telephone Number	:	336-271-5888
Fax Number	:	336-271-5882

Authorized Official
Title or Position	:	CEO
Name	:	MRS. ERICA D CARTER
Credential	:
Telephone Number	:	336-271-5888

Provider Enumeration Date	:	03/24/2011
Last Update Date	:	05/09/2011

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