Provider Demographics
NPI:1326372020
Name:SPECIAL CARE
Entity Type:Organization
Organization Name:SPECIAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-275-6266
Mailing Address - Street 1:2701 S ELM EUGENE ST
Mailing Address - Street 2:SUITE 'C'
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-3634
Mailing Address - Country:US
Mailing Address - Phone:336-275-6266
Mailing Address - Fax:336-275-6289
Practice Address - Street 1:6113 BLUE LANTERN RD
Practice Address - Street 2:
Practice Address - City:GIBSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:27249-8737
Practice Address - Country:US
Practice Address - Phone:336-449-5690
Practice Address - Fax:336-449-4051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-28
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC041-071310500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310500000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Mental Illness