Organization · Type 2 NPI

Changing Phases Behavioral Support

Emotionally Disturbed Childrens' Residential Treatment Facility · Greensboro, NC

NPI number 1811057045 Active

Practice location

1609 Clemmons St
Greensboro, NC 27406-2870

Call (336) 333-2542 Map

Fax (336) 333-2858

Mailing address

338 N Elm St, Suite 215
Greensboro, NC 27401-2177

Specialties and licenses

Taxonomy	Code	License
Community/Behavioral Health Agency	251S00000X	None listed
Emotionally Disturbed Childrens' Residential Treatment Facility Primary	322D00000X	MHL-041-794 (NC)
Emotionally Disturbed Childrens' Residential Treatment Facility	322D00000X	MHL-041-894 (NC)

Emotionally Disturbed Childrens' Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.

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About NPI 1811057045

Changing Phases Behavioral Support's National Provider Identifier is 1811057045, issued on Dec 11, 2006. The primary taxonomy on file is Emotionally Disturbed Childrens' Residential Treatment Facility (322D00000X), and the practice location is in Greensboro, NC. The record was last updated on Mar 12, 2012.