Pelham Gardens
Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Pelham, NC
NPI 1740517697 · NPPES record last updated Nov 17, 2009
Key facts
- NPI
- 1740517697
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
- Legal business name
- PELHAM GARDENS
- Practice address
- 306 Old Hwy 29
Pelham, NC 27311 - Phone
- (336) 210-1446
- NPI assigned
- Nov 13, 2009
- Organization subpart
- No
Authorized official
- Name
- Mr. Gregory Vincent
- Title
- Owner/Ceo
- Phone
- (336) 210-1446
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- Pelham Gardens
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | Yes |
Addresses
Primary practice location
306 Old Hwy 29
Pelham, NC 27311
Mailing address
PO Box 38551
Greensboro, NC 27438
Other names
- Pelham Gardens
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- Glory Train Transportation LLC
- Aline Tilithia Kent
- Lucy Nannie Hairston
- Valerie Long Russell
- Calvin J Slade Sr.
- Corey Lewis Tarpley
- V Mobile
All providers in Pelham, NC · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 17, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.