Provider Demographics
NPI:1700683851
Name:BROOKSTONE TERRACE OF GREENSBORO
Entity type:Organization
Organization Name:BROOKSTONE TERRACE OF GREENSBORO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:D
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-687-2580
Mailing Address - Street 1:915 W COOKSEY DR
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27360-3359
Mailing Address - Country:US
Mailing Address - Phone:336-472-7171
Mailing Address - Fax:336-472-8270
Practice Address - Street 1:3896 N ELM ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27455-2596
Practice Address - Country:US
Practice Address - Phone:336-286-1235
Practice Address - Fax:336-286-9863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility