Provider Demographics
NPI:1235785726
Name:EIGHTH MONTH VENTURES, LLC
Entity Type:Organization
Organization Name:EIGHTH MONTH VENTURES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:BLACKMON
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:336-210-0893
Mailing Address - Street 1:405 BANNER AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-4301
Mailing Address - Country:US
Mailing Address - Phone:336-669-4450
Mailing Address - Fax:
Practice Address - Street 1:405 FRANKLIN BLVD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-4610
Practice Address - Country:US
Practice Address - Phone:336-669-4450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-12
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility