Lydia's Home

NPI 1205011012 - Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X

NPI Details
NPI 1205011012
Enumeration Date 12/31/2007
Last Updated 04/25/2012
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name MELISSA MELISSA
Position OWNER
Phone (336) 456-7248
Fax
Practice Location
2704 GRIMSLEY ST
GREENSBORO NC, 27403-3138, US
Phone (336) 456-7248
Fax
Business Location
2704 GRIMSLEY ST
GREENSBORO NC, 27403-3138, US
Phone (336) 456-7248
Fax
Toxanomy
Taxonomy Code 322D00000X
License State North Carolina
License Number MHL041850
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According to our database, Lydia's Home NPI is 1205011012, taxonomy code is 322D00000X and license number is MHL041850, license state is located at North Carolina. Lydia's Home physically located at 2704 Grimsley St, Greensboro NC, 27403-3138. NPI Number 1033115704 has the healthcare provider type.

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1205011012 NPI number is provided on an as is basis without warranty of any kind. 1205011012 is maintained by the National Plan & Provider Enumeration System. The contents of Lydia's Home are for informational purposes only.