OrganizationActive
Black & Associates Global Inc
NPI 1598894842 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Greensboro, NC
Provider details
- NPI number
- 1598894842
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Ellen Black, Administrator(336) 987-0572
- License
- MHL -041-669 (NC)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000XLicense MHL -041-669 (NC)
Residential Treatment Facilities
Practice location
618 Broad Ave
Greensboro, NC 27406-1705
Phone: (336) 230-0767
Fax: (336) 454-0191
Approximate (ZIP-level) locationGet directions
Mailing address
102 Burrows Rd
Jamestown, NC 27282-8400
Other names (DBA / former)
- Doing business as
- Our Home
Registry dates
- Enumerated
- 2007-03-04
- Last updated
- 2008-07-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.