Provider Demographics
NPI:1902102221
Name:PACE OF GUILFORD AND ROCKINGHAM COUNTIES, INC
Entity Type:Organization
Organization Name:PACE OF GUILFORD AND ROCKINGHAM COUNTIES, INC
Other - Org Name:PACE OF THE TRIAD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BOARD CHAIR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-545-5400
Mailing Address - Street 1:1471 E CONE BLVD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-4533
Mailing Address - Country:US
Mailing Address - Phone:336-550-4040
Mailing Address - Fax:336-550-4044
Practice Address - Street 1:1471 E CONE BLVD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-4533
Practice Address - Country:US
Practice Address - Phone:336-550-4040
Practice Address - Fax:336-550-4044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-03
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care