NPI 1548319247

John & Jennerine Enterprise, INC.

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility Reidsville, NC

Practice location

Address: 3008 Nc Highway 150, Reidsville, NC 27320-8112
Phone: (336) 342-2609
Fax: (336) 342-6362
Mailing address: PO Box 1583, Reidsville, NC 27323-1583

Authorised official

Name: John Robert Wallace
Title: Owner/Eft
Phone: (336) 342-2609

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X Licence MHL-079-058 (NC)

Other Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in North Carolina →

Registry record

NPI: 1548319247
Entity type: Organization
NPI issued: 10 Jan 2007
Record last updated: 25 Apr 2011

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.