CHANGING PHASES BEHAVIORAL SUPPORT NPI 1811057045

NPI Information

CHANGING PHASES BEHAVIORAL SUPPORT is a residential treatment facility emotionally disturbed children in Greensboro, NC. The provider is a residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. CHANGING PHASES BEHAVIORAL SUPPORT NPI is 1811057045. The provider is registered as an organization entity type.
The provider Is Doing Business As Changing Phases Behavioral Support One.

The provider's business location address is:

1609 CLEMMONS ST
GREENSBORO, NC
ZIP 27406-870
Phone: (336) 333-2542
Fax: (336) 333-2858

The provider's authorized official is Quinten Cullins .
The authorized official title is Program Director and has the following contact phone number (336) 333-2542.

The enumeration date for this NPI number is 12/11/2006 and was last updated on 3/12/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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