Provider Demographics
NPI:1548694268
Name:THE GUILFORD COUNTY RESOURCE AND REFERRAL CENTER
Entity type:Organization
Organization Name:THE GUILFORD COUNTY RESOURCE AND REFERRAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CHANCELLOR
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LCAS-A
Authorized Official - Phone:336-554-1624
Mailing Address - Street 1:4701 PENNOAK LN APT K
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-4099
Mailing Address - Country:US
Mailing Address - Phone:336-554-1624
Mailing Address - Fax:
Practice Address - Street 1:725-B W. MAIN STREET
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NC
Practice Address - Zip Code:27282
Practice Address - Country:US
Practice Address - Phone:336-454-1140
Practice Address - Fax:336-454-1180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-29
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3400251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health