OrganizationActive
Classique Residential Services-Llc
NPI 1396924221 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Greensboro, NC
Provider details
- NPI number
- 1396924221
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Henry Lutterodt, Executive Director(336) 510-6966
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Residential Treatment Facilities
Practice location
340 Burlingate Dr Apt E
Greensboro, NC 27407-1295
Phone: (336) 510-6966
Approximate (ZIP-level) locationGet directions
Mailing address
340 Burlingate Dr Apt E
Greensboro, NC 27407-1295
Registry dates
- Enumerated
- 2007-10-27
- Last updated
- 2007-10-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.