Coltrane'S Group Home

LBN: Coltrane'S Group Home
Coltrane'S Group Home is an health care organization with primary practice located at 3811 Repon St , Greensboro NC 27407-5536. The organization recently has only one registered license in Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, which is considered as the primary health care specialty. Coltrane'S Group Home can be contacted via phone (336) 299-1419, or through Coltrane, Lathay via phone (336) 669-2819.

Contact Information

Primary practice address
3811 Repon St Greensboro NC 27407-5536
Phone: (336) 299-1419
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Coltrane, Lathay
Phone: (336) 669-2819

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320900000X MHL-041-620 North Carolina

Profile Details

NPI number 1437324902
LBN Legal business name Coltrane'S Group Home
DBA Doing business as
Authorized official Coltrane, Lathay
Entity Organization
Organization subpart 1 No
Enumeration date Apr 25th, 2008
Last updated Apr 25th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437324902 NPPES
North Carolina MEDICAID 7804354

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