OrganizationActive
Coltrane'S Group Home
NPI 1437324902 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Greensboro, NC
Provider details
- NPI number
- 1437324902
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Lathay Coltrane, Ceo(336) 669-2819
- License
- MHL-041-620 (NC)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000XLicense MHL-041-620 (NC)
Residential Treatment Facilities
Practice location
3811 Repon St
Greensboro, NC 27407-5536
Phone: (336) 299-1419
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 79113
Greensboro, NC 27417-9113
Registry dates
- Enumerated
- 2008-04-25
- Last updated
- 2008-04-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.