MEDICARE: POSITIVE CARE

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	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility	MHL-041-765	NC

General Provider Information

NPI Number	:	1891878518
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POSITIVE CARE

Provider Business Mailing Address
First Line	:	2200 SHARPE RD
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27406-8503
Country	:	US
Telephone Number	:	336-697-8700
Fax Number	:	336-697-8705

Provider Business Practice Location Address
First Line	:	2200 SHARPE RD
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27406-8503
Country	:	US
Telephone Number	:	336-697-8700
Fax Number	:	336-697-8705

Authorized Official
Title or Position	:	QUALIFIED PROFESSIONAL
Name	:	MR. MARZELL PARKER SR.
Credential	:	MS
Telephone Number	:	336-686-8582

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	11/19/2014

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Directions to “POSITIVE CARE ” Practice Location

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