NPI 1326372020

Special Care

Organisation Mental Illness Intermediate Care Facility Gibsonville, NC

Practice location

Address: 6113 Blue Lantern Rd, Gibsonville, NC 27249-8737
Phone: (336) 449-5690
Fax: (336) 449-4051
Mailing address: 2701 S Elm Eugene St Suite 'C', Greensboro, NC 27406-3634

Authorised official

Name: Henry L. Simmons
Title: President
Phone: (336) 275-6266

Registered specialties

Mental Illness Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310500000X Licence 041-071 (NC)

Other Intermediate Care Facility, Mental Illness providers in North Carolina →

Registry record

NPI: 1326372020
Entity type: Organization
NPI issued: 28 Sep 2009
Record last updated: 29 Sep 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.