Provider Demographics
NPI:1053456624
Name:GREENSBORO RETIREMENT CENTER INC
Entity Type:Organization
Organization Name:GREENSBORO RETIREMENT CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:H
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:336-852-5810
Mailing Address - Street 1:3301 GAR PL
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-5625
Mailing Address - Country:US
Mailing Address - Phone:336-852-5810
Mailing Address - Fax:336-852-5839
Practice Address - Street 1:3301 GAR PL
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-5625
Practice Address - Country:US
Practice Address - Phone:336-852-5810
Practice Address - Fax:336-852-5839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHAL-041-003310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility