Classique Residential Services-LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

CLASSIQUE RESIDENTIAL SERVICES-LLC

Practice address

340 Burlingate Dr Apt E
Greensboro, NC 27407-1295

Phone

(336) 510-6966

NPI assigned

Oct 27, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Henry Augustus Lutterodt, MS

Title

Executive Director

Phone

(336) 510-6966

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193443200000",
    "number": "1396924221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 BURLINGATE DR APT E",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274071295",
            "telephone_number": "336-510-6966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 BURLINGATE DR APT E",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274071295",
            "telephone_number": "336-510-6966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLASSIQUE RESIDENTIAL SERVICES-LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-27",
        "last_updated": "2007-10-27",
        "status": "A",
        "authorized_official_last_name": "LUTTERODT",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "AUGUSTUS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "336-510-6966",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.