Provider Demographics
NPI:1861714511
Name:STROUD HOUSE
Entity type:Organization
Organization Name:STROUD HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:PORSHA
Authorized Official - Middle Name:LASHAWEN
Authorized Official - Last Name:STROUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-988-1157
Mailing Address - Street 1:200 E MCCULLOCH ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-1439
Mailing Address - Country:US
Mailing Address - Phone:336-617-4612
Mailing Address - Fax:336-617-4612
Practice Address - Street 1:200 E MCCULLOCH ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-1439
Practice Address - Country:US
Practice Address - Phone:336-617-4612
Practice Address - Fax:336-617-4612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility